Health-Related Quality of Life of People with Chronic Kidney Disease in Low- and Middle-Income Countries: A Literature Review

Abstract

Complications of chronic kidney disease (CKD) impair cardiovascular health and quality of life. Health-related QoL (HRQoL) is influenced by cultural perspectives, social environment and health behaviors that vary across countries with varying income. Therefore, present review aims to report HRQoL in people with CKD and factors influencing HRQoL in low and middle-income countries (LMIC). Fifty relevant studies were reviewed following literature search in Cochrane Library, Pub Med, Google Scholar and CINAHL databases using keywords: Quality of life, chronic kidney disease and LMIC. HRQoL was poor in people with CKD compared to healthy individuals. QoL was positively influenced by younger age, male gender, higher socioeconomic and status of employment. Presence of comorbidities, anemia and low hemoglobin levels were associated with poor QoL. Intrinsic and extrinsic factors influencing HRQoL were similar in people with CKD in LMIC and high-income countries. However, overall HRQoL and mental-health scores were lower with reference to high-income countries. Therefore, a multipronged approach designed towards prevention of kidney disease, early detection and management to delay end-stage kidney disease through health education, modification of risk factors, accessible and affordable comprehensive management of kidney disease is necessary. In resource constrained settings of LMIC, strategic investment in planning and implementation of prophylactic and monitoring measures will help to reduce huge financial costs necessary for management and improvement of HRQoL of people with CKD.