Self-Reported Burden and Health-Related Quality of Life in Acute Kidney Injury Survivors Compared with Patients with Advanced CKD.

KEY POINTS

Patients recently discharged after a severe AKI episode have a low health-related quality of life. This self-reported quality of life is comparable with that of people living with advanced CKD.

BACKGROUND

Survivors of severe AKI are at risk of increased morbidity. There are limited data of the quality of life (QOL) of patients who recently have had an AKI episode. The purpose of this study was to explore the health-related QOL of severe AKI survivors when compared with patients living with advanced CKD.

METHODS

A prospective observational cohort study of severe AKI survivors who attended follow-up in a specialized post-AKI clinic was compared with a cohort of patients with advanced stage 4 or 5 CKD followed in a dedicated nephrology clinic. Self-reported health-related QOL was determined with the Treatment Burden Questionnaire (TBQ) and compared between both groups.

RESULTS

A total of 100 participants were included in this analysis. As opposed to participants with CKD, AKI survivors were younger (median age: 63 [52–72] versus 72 [62–79] years) and had lower comorbidities (median Charlson index: 5 [2–7] versus 8 [6–9]) and higher eGFR at follow-up (median: 60 [40–82] versus 15 [12–20]). The overall QOL reported by AKI survivors was not statistically different from participants with advanced CKD (median TBQ score: 19.0 [6.5–43.8] versus 25 [12.8–43.0]), = 0.45). The only domain where a significant difference was observed between the two cohorts was dietary restrictions ( = 0.037). A negative correlation between age and TBQ score was observed (Spearman's rank: −0.23 [ = 0.02]), especially in participants with CKD (−0.51 [ = 0.001]), meaning older participants reported a lower effect on health-related QOL, and between eGFR and TBQ (−0.20 [ = 0.049]), meaning participants with lower eGFR reported lower health-related QOL. No correlation was observed for hospital length of stay, burden of medication, or follow-up duration since hospital discharge.

CONCLUSIONS

This study showed that health-related QOL of patients recently discharged after a severe AKI episode is comparable with the low QOL reported by patients living with advanced CKD. How to integrate that information into clinical practice when offering post-AKI care requires further research.