Abstract
Health-related quality of life (HRQoL) is likely to deteriorate with the progression of chronic kidney disease (CKD). This change may be worsened by low health literacy (HL). We performed a longitudinal study at over 20 dialysis clinics in Slovakia (n = 413; mean age = 64.8 years; males = 58.4%). We assessed the association of three HL groups with a change in HRQoL over two years using binary logistic regression adjusted for type of vascular access, dialysis effectiveness, comorbidity, age and gender. We found that patients with low HL had poorer HRQoL at baseline in comparison to high-HL patients. We did not find significant associations of lower HL with the deterioration of mental or physical HRQoL after two years. In the adjusted model, patients with lower HL were not more likely to have deteriorated physical (low-HL patients: odds ratio/95% confidence interval: 0.99/0.53–1.84; moderate-HL patients: 0.97/0.55–1.73) or mental HRQoL (low-HL patients: 1.00/0.53–1.87; moderate-HL patients: 0.95/0.53–1.70) in comparison to high-HL patients. The HRQoL of lower-HL patients is worse at baseline but develops similarly to that of high-HL patients during dialysis treatment. Their relative HRQoL, thus, does not worsen further, but it does not improve either. Tailoring care to their needs may help to decrease the burden of low HL in dialysed patients.
Highlights
chronic kidney disease (CKD) is associated with increased morbidity and mortality [5], and with a higher burden observed in countries with a lower level of
Follow-up information was obtained on 413 dialysed patients; 154 patients were lost to follow-up due to various reasons specified in the flow chart (Figure 1)
We explored the association of health literacy (HL) with changes in Health-related quality of life (HRQoL) during dialysis treatment in dialysed patients
Summary
Chronic kidney disease (CKD) is a serious public health problem worldwide [1,2]. In the last 30 years, the global prevalence of CKD has increased by almost 30%, resulting in a prevalence of 9.1% in 2017 [3]; the global incidence of stage 5 CKD has increased rapidly [4]. CKD poses a great challenge for health policies and finances, especially regarding the treatment of stage 5 CKD, the final and most advanced stage when renal replacement therapy, such as dialysis (haemodialysis/peritoneal dialysis) or kidney transplantation, is required to keep patients alive. CKD is associated with increased morbidity and mortality [5], and with a higher burden observed in countries with a lower level of
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