Abstract
Background: Chronic kidney disease (CKD) is increasing in prevalence worldwide. Progression of CKD to end-stage renal disease (ESRD) can result in the requirement for renal replacement therapy, which incurs considerable healthcare costs and imposes restrictions on patients’ daily living. This systematic review was conducted to inform understanding of the humanistic and economic burden of CKD by collecting quality of life (QoL), symptom burden, and cost and resource use data, with a focus on the impact of disease progression. Methods: Embase, MEDLINE, the Cochrane Library, and conference proceedings were searched in May 2017 according to predefined inclusion criteria. Data were extracted for full publications reporting either QoL or symptom burden (published 2007–2017; reporting data from ≥ 100 patients) or costs and resource use (published 2012–2017). Relevant QoL studies were those that used the 6-dimension or 8-, 12-, or 36-item Short-Form Health Surveys, 5-dimension EuroQol questionnaire, Healthy Days/Health-Related Quality of Life questionnaire, or Kidney Disease Quality of Life Questionnaire. Results: Data were extracted from 95 studies reporting QoL data, 47 studies reporting cost and resource use data, and eight studies reporting descriptions of symptoms; 12 studies (seven QoL; five costs/resource use) reported data for patients with and without CKD, and 15 studies (seven QoL; eight costs/resource use) reported data by disease stage. Patients with CKD, including those with ESRD, had worse QoL than those with normal kidney function, and incurred higher healthcare costs. Disease progression was associated with cost increases, particularly for later stages and in patients receiving dialysis. Increasing CKD severity was also associated with reductions in QoL, although not all studies identified showed a consistent decrease with increasing disease stage. Conclusions: The presence of CKD and CKD progression are associated with reductions in patients’ QoL and increased economic impact. This may be mitigated by interventions that slow progression.
Highlights
Chronic kidney disease (CKD) is characterized by a gradual loss of kidney function over time
For the humanistic burden systematic reviews (SRs), data were not extracted if the study population included fewer than 100 patients with CKD or if the study did not use any of the following instruments:
Search results In total, 5219 papers were identified in the initial searches, of which 1114 papers were removed as duplicates, and 4105 were included for screening by abstract and title
Summary
Chronic kidney disease (CKD) is characterized by a gradual loss of kidney function over time. The prevalence of the disease is rising, owing in part to an increase in the median age of populations worldwide, and the growing number of individuals with diabetes mellitus (DM) or hypertension[1] These conditions are the two main causes of CKD and are commonly present in patients with diminished renal function[2]. When CKD progresses, patients may experience complications such as anaemia, cardiovascular disease (CVD), peripheral arterial disease, pruritus, and increased risk of infection Both disease progression and its associated complications require medical treatment, which further impacts patients’ quality of life (QoL) and contributes to the humanistic and economic burden of CKD4,5. Progression to end-stage renal disease (ESRD) has a significant effect on patients’ daily lives and is often associated with considerable costs due to the common requirement for renal replacement therapy (RRT) via dialysis or kidney transplantation[1]. Relevant QoL studies were those that used the 6-dimension or 8-, 12-, or 36-item Short-Form Health Surveys, 5-dimension EuroQol questionnaire, Healthy Days/Health-Related Quality of Life questionnaire, or Kidney Disease Quality of Life Questionnaire
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call