Impact of Comorbidities on Health-Related Quality of Life in Patients with Different Stages of Chronic Kidney Disease in Babil Governorate, Iraq

Abstract

Background:Chronic kidney disease is associated with different comorbid conditions. Most persons with mild-to-moderate CKD reported reductions in at least one health-related quality of life (HRQOL) domain, which was independently associated with comorbidities.

Objectives: The present study aims to assess the impact of comorbidities on HRQOL in patients with stage3-5 chronic kidney disease (CKD) in Babil Governorate, Iraq.

Methods: A cross-sectional study among adults with CKD (eGFR<60 mL/min/1.73m²) has been used. Participants diagnosed with CKD stage 3-4 by physicians and adult patients diagnosed with end-stage renal disease (ESRD) receiving haemodiaylsis (HD) treatment in Kidney Centers at Marjan Medical City and Imam-Alsadiq General Hospital were enrolled. Each participant completed the Kidney Disease Quality of Life (KDQoL™-36) questionnaire, which is comprised of two composite measures of physical and mental health and 3 kidney disease specific subscales. Analysis of data was carried out using the available statistical package of SPSS-27.

Results: A convenience sample of 206 patients were studied with a mean age of 55.2 (SD = 14.7) years and more than half 109 (52.9%) were males. Most of the participants (43.2%) had two comorbidities. The three most common comorbidities were hypertension (83.5%), diabetes mellitus (42.7%), cardiovascular disease (45.6%).The Meanscores for overall HRQOL, physical component summary, mental component summary, symptom/problem list, effects of kidney disease and burden of kidney disease scales were (58.1±13), (38.1±27.9), (52.9±18.7), (70.1±11.7), (76.5±13.4), and (30.2±31.2), respectively. A Kruskal-Wallis test revealed a statistically significant difference between overall HRQOL score and CKD stages, χ²(2) = 100.51, p = 0.000. Overall HRQOL score were lower in stage 5 HD in comparison to stage 4 and stage 3. A significant reduction in overall HRQOL score with increase number of comorbidities, χ²(3) = 9.10, p = 0.028. Among comorbidities, cardiovascular disease, chronic respiratory disorder, HCV infection were associated with overall HRQOL score, p value < 0.05.

Conclusion: Comorbidities considerably impair the HRQOL among CKD patients. over ninety percent of patients with CKD had comorbidities. Regular organization of health education awareness programs on the prevention of CKD and its associated comorbidities among the general public should be done.