Health-related quality of life in Australian adults with renal insufficiency: a population-based study.
BACKGROUND
Health-related quality of life is increasingly recognized as an important outcome in clinical research and patient care. Although there are a large number of reports of quality of life in the setting of end-stage renal disease, the impact of lesser degrees of renal impairment in the general population has not been described.


METHODS
Data relating to quality of life measured by the Medical Outcomes Study 36-Item Short Form (SF-36) was available for 10,525 participants (93.6%) of the Australian Diabetes, Obesity and Lifestyle Study, a randomly selected representative sample of the Australian population aged 25 years or older. Results are examined by category of renal function (Cockcroft-Gault estimated glomerular filtration rate: normal, > or =60 mL/min/1.73 m2; renal insufficiency, <60 mL/min/1.73 m2).


RESULTS
Significant impairment in health-related quality of life was seen with renal insufficiency for all SF-36 scales except Vitality and Mental Health. Adjusting for the substantial comorbidity associated with renal insufficiency, scores for Physical Functioning, Role-Physical, General Health, Vitality, and Role-Emotional were significantly lower. Examination of age-specific effects on health-related quality of life showed that mental health was particularly impaired in the younger age group, and Physical Functioning, in the older age group with renal insufficiency. Patterns of impairment were similar in men and women.


CONCLUSION
Results from this study indicate that the current emphasis on clinical interventions aimed at preserving renal function are likely to improve the negative impact of kidney disease on health-related quality of life; however, prospective studies are needed to confirm these findings.