title: Quality of life and mortality from a nephrologist's view: a prospective observational study.
abstract: BACKGROUND
  Although health-related quality of life (HRQOL) is a potential independent predictor of mortality, nephrologists have shown little interest in HRQOL with respect to mortality in chronic kidney disease (CKD). The aim of this article is to evaluate the impact of HRQOL on mortality in the elderly, who are likely to develop or already have CKD.
  
  
  METHODS
  Among 1,000 randomly sampled participants aged more than 65 years (sourced from the Korean Longitudinal Study on Health and Ageing), 944 subjects were evaluated for HRQOL. HRQOL was assessed using a 36-item Short-Form health survey (SF36). A cumulative survival rate was calculated according to tertiles of SF36 scores and classified by the presence of CKD (estimated GFR <60 ml/min/1.73 m2).
  
  
  RESULTS
  Among 944 subjects, 46.6% had CKD. CKD patients had lower total and physical component scores compared with subjects without CKD. The 3-year cumulative survival rate was 90.0% (non-CKD vs. CKD: 92.6% vs. 87.4%, P = 0.005 by log rank test). After adjusting for multiple variables, a reduced SF36 score (physical and mental components) was a strong predictor of all-cause mortality. Physical components were consistently able to predict mortality after CKD classification, but mental components were statistically significant only in the CKD group.
  
  
  CONCLUSIONS
  In addition to traditional risk factors of mortality, nephrologists should be aware of HRQOL as a predictor of mortality and should make efforts to improve HRQOL in CKD patients.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. hansway@medimail.co.kr
authors.forename: Seung Seok
authors.initials: SS
authors.lastname: Han
authors.forename: Ki Woong
authors.initials: KW
authors.lastname: Kim
authors.forename: Ki Young
authors.initials: KY
authors.lastname: Na
authors.forename: Dong-Wan
authors.initials: DW
authors.lastname: Chae
authors.forename: Yon Su
authors.initials: YS
authors.lastname: Kim
authors.forename: Suhnggwon
authors.initials: S
authors.lastname: Kim
authors.forename: Ho Jun
authors.initials: HJ
authors.lastname: Chin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality* / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D009398:Nephrology / Q000379:methods; D010819:Physician's Role / Q000523:psychology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D056910:Republic of Korea / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends