title: The association of moderate renal dysfunction with impaired preference-based health-related quality of life: third Korean national health and nutritional examination survey.
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 3(rd) 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 m(2). 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 m(2). Participants with an eGFR of 30.0-59.9 mL/min/1.73 m(2) 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 m(2), 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 m(2) 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.
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
authors.forename: Hajeong
authors.initials: H
authors.lastname: Lee
authors.forename: Yun Jung
authors.initials: YJ
authors.lastname: Oh
authors.forename: Myounghee
authors.initials: M
authors.lastname: Kim
authors.forename: Ho
authors.initials: H
authors.lastname: Kim
authors.forename: Jung Pyo
authors.initials: JP
authors.lastname: Lee
authors.forename: Sejoong
authors.initials: S
authors.lastname: Kim
authors.forename: Kook-Hwan
authors.initials: KH
authors.lastname: Oh
authors.forename: Ho
authors.initials: H
authors.lastname: Jun Chin
authors.forename: Kwon Wook
authors.initials: KW
authors.lastname: Joo
authors.forename: Chun Soo
authors.initials: CS
authors.lastname: Lim
authors.forename: Suhnggwon
authors.initials: S
authors.lastname: Kim
authors.forename: Yon Su
authors.initials: YS
authors.lastname: Kim
authors.forename: Dong Ki
authors.initials: DK
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006305:Health Status Indicators; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys / Q000379:methods*; D011788:Quality of Life; D056910:Republic of Korea / Q000453:epidemiology; D055815:Young Adult