dc.contributor.author | Da Silva-Gane, Maria | |
dc.contributor.author | Wellsted, D. | |
dc.contributor.author | Greenshields, Hannah | |
dc.contributor.author | Norton, Sam | |
dc.contributor.author | Chandna, Shahid M. | |
dc.contributor.author | Farrington, Ken | |
dc.date.accessioned | 2013-02-12T15:30:06Z | |
dc.date.available | 2013-02-12T15:30:06Z | |
dc.date.issued | 2012-12-07 | |
dc.identifier.citation | Da 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 (CJASN) , vol. 7 , no. 12 , pp. 2002-2009 . https://doi.org/10.2215/CJN.01130112 | |
dc.identifier.issn | 1555-905X | |
dc.identifier.other | ORCID: /0000-0002-2895-7838/work/31148137 | |
dc.identifier.uri | http://hdl.handle.net/2299/9985 | |
dc.description.abstract | BACKGROUND 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.format.extent | 1085027 | |
dc.language.iso | eng | |
dc.relation.ispartof | Clinical Journal of the American Society of Nephrology (CJASN) | |
dc.title | Quality of Life and Survival in Patients with Advanced Kidney Failure Managed Conservatively or by Dialysis | en |
dc.contributor.institution | Applied and Practice-based Research | |
dc.contributor.institution | School of Life and Medical Sciences | |
dc.contributor.institution | Health & Human Sciences Research Institute | |
dc.contributor.institution | Department of Psychology | |
dc.contributor.institution | Psychology | |
dc.contributor.institution | Centre for Lifespan and Chronic Illness Research | |
dc.contributor.institution | Health and Clinical Psychology Research Group | |
dc.contributor.institution | Health Services and Medicine | |
dc.contributor.institution | Behaviour Change in Health and Business | |
dc.contributor.institution | Statistics and Methodology Research group | |
dc.contributor.institution | Health Services Research group | |
dc.contributor.institution | Centre for Postgraduate Medicine | |
dc.contributor.institution | Postgraduate Medicine | |
dc.contributor.institution | Pharmacology and Clinical Science Research | |
dc.description.status | Peer reviewed | |
rioxxterms.versionofrecord | 10.2215/CJN.01130112 | |
rioxxterms.type | Journal Article/Review | |
herts.preservation.rarelyaccessed | true | |