Health-Related Quality of Life and Dialysis Dependence in Critically Ill Patient Survivors of Acute Kidney Injury

Abstract

Background: Acute kidney injury is a common disorder in critical ill patients and it is associated with high mortality. Few studies focus on long-term perspectives such as health-related quality of life (HRQOL) and dialysis dependence. Methods: Prospective cohort study at the intensive care unit (ICU) of a Brazilian tertiary hospital. All patients requiring dialysis over a 2-year enrollment period were included. The Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) assessed the HRQOL along with patient status and dialysis dependence. Results: 408 patients (11%) required dialysis. ICU, hospital, and after-hospital cumulative fatality rates were 70%, 74%, and 80%, respectively. A total of 68 of 82 eligible patients were interviewed in an average of 256 days after hospital discharge, while 8 patients (11.8%) were in regular dialysis. There was no association between Acute Physiology and Chronic Health Evaluation II score, use of vasopressors, mechanical ventilation, creatinine, number of dialysis, and SF-36 scores. Better HRQOL was associated with previous conditions, as younger age and no chronic kidney disease; condition related to severity of acute illness, as have not had sepsis, short period at ICU, and hospital; and conditions after discharge, considered working currently. Conclusions: Previous chronic kidney disease was strongly associated with permanence in dialysis and lower further HRQOL. Younger survivors who have not had sepsis or long stays at hospitals, able to return to their jobs, had better HRQOL.

Population-based incidence, mortality and quality of life in critically ill patients treated with renal replacement therapy: a nationwide retrospective cohort study in finnish intensive care units

“…Several previous studies have reported lower HRQoL among RRT patients compared to matched general population [20,21]. Morsch et al [34] found that younger and less severely ill RRT-treated patients had better HRQoL as measured with the SF-36 instrument than older patients with long hospital stay. Johansen et al [35] reported an extremely low HRQoL among 60-day survivors after RRT.…”

Quality of Life in Peritoneal and Hemodialysis Patients in China

“…[4][5][6][7][8][9] A number of studies have indicated that the QOL of dialysis patients is greatly impaired compared to general population. 10,11 However, differences in QOL between PD and HD patients have not been clearly identified.…”

Quality of life of critically ill patients in a developing country: a prospective longitudinal study

“…This suggests that despite of socioeconomic differences with possible variations in health status and outcomes across the world21, 22 ) , physical component is more compromised than mental component as also reported by Hofhuis et al9 ) . Moreover, the influence of age has been encountered in other studies, including those from developing countries13, 14 ) .…”

“…A Brazilian study13 ) assessed QoL of critically ill survivors who presented acute kidney injury. It was a large cohort study, which found that chronic kidney injury, septic shock, older age and longer ICU stay were related to worse QoL.…”

“…However, the QoL of critically ill patients after ICU and hospital discharge has been addressed mostly in developed countries6,7,8,9,10,11 ) . In the few studies conducted in developing countries, QoL was reported as declined in survivors of critically ill patients after acute respiratory distress syndrome (ARDS) due H1N1 virus, acute kidney injury and severe sepsis12,13,14 ) . On top of that, the percentage of mortality in tertiary hospital in India was reported still high for elderly patients15 ) .…”