How do people with chronic kidney disease value cancer-related quality of life?
OBJECTIVE
To estimate the utility-based quality of life (QOL) of people with chronic kidney disease (CKD) and to estimate the QOL associated with two hypothetical colorectal cancer health states.


METHODS
A cross-sectional study was conducted in people with CKD (stages 3-5, transplant recipients and those on dialysis) from three centres in Sydney, Australia. We measured participants' own QOL and that of two hypothetical colorectal cancer health states using a rating scale, and a utility-based QOL measure, the time trade-off, with extremes of 0 (death) and 1 (full health).


RESULTS
Recipients of kidney transplants (n=79) had the highest mean QOL weights of 0.79 (standard deviation (SD)=0.34) compared with participants with CKD 3-5 (n=53) with mean QOL weights of 0.70 (SD=0.39), and those on dialysis (n=89), who had the lowest mean QOL weights of 0.62 (SD=0.41) (P=0.02). Having early and advanced stage colorectal cancers were valued at mean QOL weights of 0.44 (SD=0.41) and 0.12 (SD=0.25) among people with moderate stage CKD; 0.45 (SD=0.39) and 0.11 (SD=0.24) among dialysis patients; 0.62 (SD=0.36) and 0.18 (SD=0.29) among kidney transplant recipients.


CONCLUSIONS
People with CKD have poor QOL. Having coexistent illnesses such as cancer further reduces the overall well-being of individuals with kidney disease. In addition to the development of effective screening and treatment programs to improve cancer outcomes in people with CKD, our study also highlights the need for effective interventions to improve the QOL in people with CKD, particularly those with major comorbidities like cancer.
Centre for Kidney Research, The Children's Hospital at Westmead, School of Public Health, Sydney University, New South Wales, Australia. germainw@chw.edu.au
Germaine
G
Wong
Kirsten
K
Howard
Jeremy
J
Chapman
Carol
C
Pollock
Steven
S
Chadban
Glenn
G
Salkeld
Allison
A
Tong
Narelle
N
Williams
Angela
A
Webster
Jonathan C
JC
Craig
D000328:Adult; D000368:Aged; D001315:Australia; D002908:Chronic Disease; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D006435:Renal Dialysis; D018434:Sickness Impact Profile; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D026712:Value of Life