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dc.contributor.authorDa Silva-Gane, Maria
dc.contributor.authorWellsted, D.
dc.contributor.authorGreenshields, Hannah
dc.contributor.authorNorton, Sam
dc.contributor.authorChandna, Shahid M.
dc.contributor.authorFarrington, Ken
dc.identifier.citationDa Silva-Gane , M , Wellsted , D , Greenshields , H , Norton , S , Chandna , S M & Farrington , K 2012 , ' Quality of Life and Survival in Patients with Advanced Kidney Failure Managed Conservatively or by Dialysis ' , Clinical Journal of the American Society of Nephrology , vol. 7 , no. 12 , pp. 2002-2009 .
dc.identifier.otherPURE: 1021155
dc.identifier.otherPURE UUID: 7b284c35-795b-47f0-adc4-81fd365231c1
dc.identifier.otherPubMed: 22956262
dc.identifier.otherScopus: 84873567743
dc.description.abstractBACKGROUND AND OBJECTIVES: Benefits of dialysis in elderly dependent patients are not clearcut. Some patients forego dialysis, opting for conservative kidney management (CKM). This study prospectively compared quality of life and survival in CKM patients and those opting for dialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Quality-of-life assessments (Short-Form 36, Hospital Anxiety and Depression Scale, and Satisfaction with Life Scale) were performed every 3 months for up to 3 years in patients with advanced, progressive CKD (late stage 4 and stage 5). RESULTS: After 3 years, 80 and 44 of 170 patients had started or were planned for hemodialysis (HD) or peritoneal dialysis, respectively; 30 were undergoing CKM; and 16 remained undecided. Mean baseline estimated GFR ± SD was similar (14.0±4.0 ml/min per 1.73 m(2)) in all groups but was slightly higher in undecided patients. CKM patients were older, more dependent, and more highly comorbid; had poorer physical health; and had higher anxiety levels than the dialysis patients. Mental health, depression, and life satisfaction scores were similar. Multilevel growth models demonstrated no serial change in quality-of-life measures except life satisfaction, which decreased significantly after dialysis initiation and remained stable in CKM. In Cox models controlling for comorbidity, Karnofsky performance scale score, age, physical health score, and propensity score, median survival from recruitment was 1317 days in HD patients (mean of 326 dialysis sessions) and 913 days in CKM patients. CONCLUSIONS: Patients choosing CKM maintained quality of life. Adjusted median survival from recruitment was 13 months shorter for CKM patients than HD patients.en
dc.relation.ispartofClinical Journal of the American Society of Nephrology
dc.titleQuality of Life and Survival in Patients with Advanced Kidney Failure Managed Conservatively or by Dialysisen
dc.contributor.institutionApplied and Practice-based Research
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionHealth & Human Sciences Research Institute
dc.contributor.institutionDepartment of Psychology
dc.contributor.institutionCentre for Lifespan and Chronic Illness Research
dc.contributor.institutionHealth and Clinical Psychology group
dc.contributor.institutionHealth Services and Medicine
dc.contributor.institutionBehaviour Change in Health and Business
dc.contributor.institutionStatistics and Methodology Research group
dc.contributor.institutionHealth Services Research group
dc.contributor.institutionCentre for Postgraduate Medicine
dc.contributor.institutionPostgraduate Medicine
dc.contributor.institutionPharmacology and Clinical Science Research
dc.description.statusPeer reviewed
dc.relation.schoolSchool of Life and Medical Sciences
rioxxterms.typeJournal Article/Review

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