Open Access Research article

The association of moderate renal dysfunction with impaired preference-based health-related quality of life: 3rd Korean national health and nutritional examination survey

Hajeong Lee1, Yun Jung Oh1, Myounghee Kim2, Ho Kim2, Jung Pyo Lee3, Sejoong Kim4, Kook-Hwan Oh1, Ho Jun Chin4, Kwon Wook Joo15, Chun Soo Lim35, Suhnggwon Kim15, Yon Su Kim15 and Dong Ki Kim16*

Author Affiliations

1 Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea

2 Department of Epidemiology and Biostatistics, School of Public Health, Seoul National University Hospital, Seoul, South Korea

3 Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea

4 Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea

5 Kidney Research Institute, Seoul National University Hospital, Seoul, South Korea

6 Department of Internal Medicine, Seoul National University Hospital, 101 Daehakro, Jongro-gu, 110-744 Seoul, Republic of Korea

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BMC Nephrology 2012, 13:19  doi:10.1186/1471-2369-13-19

Published: 24 April 2012

Abstract

Background

Only a few large-scale studies have investigated the association between health-related quality of life (HRQOL) and renal function. Moreover, the HRQOL of patients with moderate renal dysfunction is frequently underestimated by healthcare providers. This study assessed the impact of renal function on preference-based HRQOL in Korean adult population.

Methods

We analyzed data for 5,555 adults from the 3rd Korean National Health and Nutritional Examination Survey 2005. The EuroQol-5D (EQ-5D) utility score was used to evaluate HRQOL. The study subjects were stratified into three groups based on their estimated glomerular filtration rates (eGFRs): ≥ 90.0, 60.0-89.9 and 30.0-59.9 mL/min/1.73 m2. Individuals with advanced renal dysfunction were excluded from the analysis.

Results

The proportions of participants who reported problems in each of the five EQ-5D dimensions increased significantly with decreasing eGFR. However, a significant decrease in the EQ-5D utility score was observed among participants with an eGFR of 30.0-59.9 mL/min/1.73 m2. Participants with an eGFR of 30.0-59.9 mL/min/1.73 m2 had an almost 1.5-fold higher risk of impaired health utility (the lowest quartile of EQ-5D utility score) compared with those participants with eGFRs ≥ 90.0 mL/min/1.73 m2, after adjustment for age, gender, health-related behaviors, socioeconomic and psychological variables, and other comorbidities. Among the five dimensions of the EQ-5D, an eGFR of 30.0-59.9 mL/min/1.73 m2 was an independent determinant of self-reported problems in the mobility and pain/discomfort dimensions.

Conclusions

Although age affects the association between renal dysfunction and the EQ-5D, moderate renal dysfunction seems to be an important determinant of impaired health utility in a general population and may affect the mobility and pain/discomfort dimensions of health utility.

Keywords:
Chronic kidney disease; EuroQol-5D; Preference-based health utility