Quality of Life and Symptom Burden among Chronic Kidney Disease of Uncertain Etiology (CKDu) Patients in Girandurukotte, Sri Lanka.

Hansani Madushika Abeywickrama,Nahoko Kakihara,Yu Koyama,Rohana Chandrajith,Utako Shimizu,Mieko Uchiyama,Swarna Wimalasiri,Nishantha Nanayakkara

doi:10.3390/ijerph17114041

Abstract

Symptom burden and health-related quality of life (HRQOL) are important predictors of how a disease affects patients’ lives, especially for endemic health problems such as chronic kidney disease of uncertain etiology (CKDu). Our study describes symptom burden, HRQOL, and associated demographic and clinical variables in CKDu patients in the Girandurukotte area, Sri Lanka. A cross-sectional study included 120 CKDu patients attending the renal clinic in the endemic area. The instruments applied were the Kidney Disease Quality of Life—Short Form (KDQOL-SFTM) version 1.3 and CKD Symptom Index—Sri Lanka. Socio-demographic, disease-related, and anthropometric variables were also investigated. The mean age of patients was 61.87 (SD 11.31), while 69.2% were male. The mean glomerular filtration rate was 28.17 (SD 14.03) mL/min/1.73 min2, and 70.8% were anemic. Bone/joint pain was the most experienced symptom while the median number of symptoms reported by patients was 5 (IQR 3–7). The mean symptom burden, physical component summary, mental component summary, and kidney-disease-specific component scores were 12.71 (SD 10.45), 68.63 (SD 19.58), 78.53 (SD 18.78), and 81.57 (SD 5.86), respectively. Age was found to be a significant predictor of HRQOL, while hemoglobin level and being a farmer were significant predictors of symptom burden. Our data indicate that CKDu patients in all stages experience at least one symptom affecting all aspects of HRQOL.

Highlights

Chronic kidney disease (CKD) of uncertain etiology (CKDu) is a form of CKD that emerged during the last two decades, which is not attributed to any conventional risk factors or known etiologies such as hypertension, diabetes, or glomerulonephritis [1,2]
The study population consisted of patients who were diagnosed with chronic kidney disease of uncertain etiology (CKDu) by renal biopsy and/or criteria set by the Ministry of Health, Sri Lanka
This study examined the quality of life and symptom burden of CKDu patients attending a renal clinic in Sri Lanka

Summary

Introduction

Chronic kidney disease (CKD) of uncertain etiology (CKDu) is a form of CKD that emerged during the last two decades, which is not attributed to any conventional risk factors or known etiologies such as hypertension, diabetes, or glomerulonephritis [1,2]. CKDu was described among low-socioeconomic agricultural communities in South Asia (Sri Lanka, and India) and Central America (Nicaragua, El Salvador, Costa Rica, and Guatemala) [3,4,5]. CKDu is clustered in certain geographical locations of. Res. Public Health 2020, 17, 4041; doi:10.3390/ijerph17114041 www.mdpi.com/journal/ijerph

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