Health‐related quality of life and lifestyle changes in patients with chronic kidney disease and hyperkalaemia: Real‐world data from the US, five European countries and China

Abstract

Chronic kidney disease patients have impaired health-related quality of life and an increased risk of hyperkalaemia. The objective was to evaluate the impact of hyperkalaemia on health-related quality of life, and investigate lifestyle change recommendations, in these patients. The Adelphi Real World Chronic Kidney Disease Specific Programme™ was used. Data were collected from physicians and patients with non-dialysis dependent stage 3a, 3b and 4 chronic kidney disease from the US, France, Germany, Spain, Italy, the UK and China. Patients completed the Kidney Disease Quality of Life Instrument and EuroQol-5D-3L. Analyses compared data between hyperkalaemic (serum potassium >5.0mmol/L) and normokalaemic (serum potassium 3.5-5.0mmol/L) patients. Overall, 1149 patients were included (hyperkalaemic: n=216, normokalaemic: n=933; US: n=376, Europe: n=490, China: n=283). Hyperkalaemic vs normokalaemic patients experienced more symptoms (P<.001) and had numerically lower scores, indicating poorer health-related quality of life, in all Kidney Disease Quality of Life domains, with significant differences for three/five domains. Hyperkalaemic patients reported numerically lower EuroQol-5D-3L utility index and visual analogue scores, indicating poorer health status, than normokalaemic patients. A higher proportion of hyperkalaemic than normokalaemic patients were recommended to reduce dietary potassium (P<.05). More normokalaemic than hyperkalaemic patients reported making a radical change in five/six recommended lifestyle changes, with the difference significant for four/six recommendations. Hyperkalaemia is associated with an incremental impairment of the health-related quality of life in chronic kidney disease patients. A better understanding of the impact of hyperkalaemia in these patients could improve patient outcomes.