Abstract

Social functioning is a key aspect of daily life and is significant to patients living with chronic kidney disease (CKD) and their caregivers. Many patients with CKD experience debilitating symptoms and treatment burden which can diminish their social functioning and thereby overall social health, which is the aspect of a person's well-being relating to their interactions and connections with others.For patients with CKD, the symptoms (such as fatigue and pain), burden of ongoing treatments, including kidney replacement therapies, and medication side effects can impair socially functioning. Having to manage responsibilities of self-management, which can include time consuming and invasive treatments such as dialysis, can severely limit social functioning for patients with CKD. This can lead to poor social connections at many levels including with family, friends, peers and colleagues, and can hinder the development of new relationships.Patients with CKD with poorer social functioning have been reported to have worse quality of life and impaired mental health. Many patients with CKD rely on an informal caregiver, usually a family member or friend, to assist with management of their disease. This can place strain on the caregiver, further limiting opportunities for social connections for both the patient and caregiver. While social functioning is critical for the overall well-being of patients with CKD, it remains under addressed clinically and patient-reported outcome measures (PROMs) to assess social functioning are limited.The objective of this article is to define social functioning, discuss the impacts of social functioning in patients with CKD and their caregivers, outline PROMS which have included assessment of social functioning, and discuss considerations in developing an appropriate PROM to measure social functioning in patients with CKD. This may help to inform the evaluation of interventions and care regarding social functioning within the CKD population.

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