title: Health-related quality of life in survivors of acute kidney injury: The Prolonged Outcomes Study of the Randomized Evaluation of Normal versus Augmented Level Replacement Therapy study outcomes.
abstract: OBJECTIVE
  While patients with chronic kidney disease have reduced health-related quality of life (HRQOL), long-term HRQOL of survivors of severe acute kidney injury (AKI) remains unclear.
  
  
  METHODS
  We analysed HRQOL from the Prolonged Outcomes Study of the Randomized Evaluation of Normal versus Augmented Level Replacement Therapy (POST-RENAL) study and compared findings with those from a general Australian adult population enrolled in the Australian Diabetes, Obesity and Lifestyle (AusDiab) study. We used a multivariate analysis adjusted for baseline characteristics along with sensitivity analysis using age and sex-matched case controls.
  
  
  RESULTS
  In the POST-RENAL study, 282 participants had HRQOL data collected using the SF-12 questionnaire. This was compared with 6330 participants from the AusDiab study. Unadjusted analyses showed that POST-RENAL participants had lower physical component scores (PCS, mean score 40.0 vs 49.8, P<0.0001) and lower mental component scores (MCS, mean score 49.8 vs 53.9, P<0.0001) than the AusDiab group. After age and sex matching, the difference in PCS and MCS remained statistically significant (P<0.0001). Advanced age, reduced renal function and albuminuria (all P ≤ 0.01) were all strongly associated with lower PCS values but not MCS values. After matching subsets of the cohorts on the basis of age, sex and renal function, PCS and MCS were lower in the POST-RENAL group (P<0.0001).
  
  
  CONCLUSIONS
  Survivors of severe AKI in the POST-RENAL study had lower physical and mental components of HRQOL compared with general population, even after adjustment for their reduced renal function. Increasing age and reduced renal function were associated with poorer physical QOL.
authors.affiliation: Renal and Metabolic Division, The George Institute for Global Health, Sydney, New South Wales, Australia.|Concord Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Amanda Y
authors.initials: AY
authors.lastname: Wang
authors.affiliation: Renal and Metabolic Division, The George Institute for Global Health, Sydney, New South Wales, Australia.|Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia.
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
authors.affiliation: Menzies School of Health Research, Darwin, Northern Territory, Australia.
authors.forename: Alan
authors.initials: A
authors.lastname: Cass
authors.affiliation: Renal and Metabolic Division, The George Institute for Global Health, Sydney, New South Wales, Australia.|Concord Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: Finfer
authors.affiliation: Renal and Metabolic Division, The George Institute for Global Health, Sydney, New South Wales, Australia.|Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Gattas
authors.affiliation: Renal and Metabolic Division, The George Institute for Global Health, Sydney, New South Wales, Australia.|St George and Sutherland Clinical School, The University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Myburgh
authors.affiliation: Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.|Concord Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Steve
authors.initials: S
authors.lastname: Chadban
authors.affiliation: Renal and Metabolic Division, The George Institute for Global Health, Sydney, New South Wales, Australia.
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Hirakawa
authors.affiliation: Renal and Metabolic Division, The George Institute for Global Health, Sydney, New South Wales, Australia.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ninomiya
authors.affiliation: Renal and Metabolic Division, The George Institute for Global Health, Sydney, New South Wales, Australia.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.affiliation: Renal and Metabolic Division, The George Institute for Global Health, Sydney, New South Wales, Australia.
authors.forename: Serigne
authors.initials: S
authors.lastname: Lo
authors.affiliation: Renal and Metabolic Division, The George Institute for Global Health, Sydney, New South Wales, Australia.
authors.forename: Federica
authors.initials: F
authors.lastname: Barzi
authors.affiliation: Renal and Metabolic Division, The George Institute for Global Health, Sydney, New South Wales, Australia.
authors.forename: Louisa
authors.initials: L
authors.lastname: Sukkar
authors.affiliation: Renal and Metabolic Division, The George Institute for Global Health, Sydney, New South Wales, Australia.|Concord Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.|Department of Renal Medicine, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
authors.forename: Meg
authors.initials: M
authors.lastname: Jardine
authors.affiliation: Renal and Metabolic Division, The George Institute for Global Health, Sydney, New South Wales, Australia.|Concord Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.|Department of Renal Medicine, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
authors.forename: Martin P
authors.initials: MP
authors.lastname: Gallagher
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D017741:Survivors; D016896:Treatment Outcome
keywords: Aus-Diab study; POST-RENAL study; acute kidney injury; health-related quality of life; prospective study