title: Health-related quality-of-life among survivors of acute kidney injury in the intensive care unit: a systematic review.
abstract: OBJECTIVE
  To summarize evidence on long-term health-related quality-of-life (HRQL) among survivors of acute kidney injury (AKI) in the intensive care unit (ICU).
  
  
  METHODS
  We performed a comprehensive search of the literature for studies reporting original data describing HRQL utilizing validated instruments. Search, study selection and data abstraction were performed in duplicate. Study quality was appraised. Due to study heterogeneity, data are primarily summarized qualitatively.
  
  
  RESULTS
  Our search yielded 2193 articles of which 18 were selected for detailed analysis. The quality of these 18 studies was generally good. Numerous HRQL instruments were utilized, and assessment occurred at variable follow-up duration (range 2 months to 14.5 years). HRQL among AKI survivors was reduced when compared to age/sex-matched populations. HRQL among survivors with and without AKI was generally described as similar beyond 6 months. Physical component domains were consistently more impaired than mental component domains. Survivors had considerable limitations in activities of daily living, implying newly acquired disability, with few returning to work. Despite diminished HRQL, patients' HRQL was generally perceived as satisfactory, and the majority would receive similar treatment again, including renal replacement therapy in the ICU, if necessary.
  
  
  CONCLUSIONS
  Among survivors of critical illness complicated by AKI, HRQL was impaired when referenced to population norms, but it was not significantly different from that of survivors without AKI. Physical limitations and disabilities were more commonly exhibited by AKI patients. Importantly, the impaired HRQL was generally perceived as acceptable to patients, most of whom expressed willingness to undergo similar treatment in the future.
authors.affiliation: Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 2-124E Clinical Sciences Building, 8440-122nd Street, Edmonton, AB, T6G 2B7, Canada.
authors.forename: Pierre-Marc
authors.initials: PM
authors.lastname: Villeneuve
authors.affiliation: Kidney Research Centre, Ottawa Hospital Research Institute, Ottawa, ON, Canada.|Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Edward G
authors.initials: EG
authors.lastname: Clark
authors.affiliation: Health Sciences Library, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Lindsey
authors.initials: L
authors.lastname: Sikora
authors.affiliation: Kidney Research Centre, Ottawa Hospital Research Institute, Ottawa, ON, Canada.|Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Manish M
authors.initials: MM
authors.lastname: Sood
authors.affiliation: Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 2-124E Clinical Sciences Building, 8440-122nd Street, Edmonton, AB, T6G 2B7, Canada. bagshaw@ualberta.ca.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Bagshaw
mesh_terms: D000203:Activities of Daily Living; D058186:Acute Kidney Injury / Q000628:therapy*; D000328:Adult; D000368:Aged; D016638:Critical Illness / Q000523:psychology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D017582:Renal Replacement Therapy / Q000523:psychology*; D017741:Survivors / Q000523:psychology*
keywords: Acute kidney injury; Critical illness; Disability; Health-related quality-of-life; Survival; Systematic review