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Critical Care
Published in: Critical Care 1/2013

Open Access 01-02-2013 | Research

The effect of acute kidney injury on long-term health-related quality of life: a prospective follow-up study

Authors: José GM Hofhuis, Henk F van Stel, Augustinus JP Schrijvers, Johannes H Rommes, Peter E Spronk

Published in: Critical Care | Issue 1/2013

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Abstract

Introduction

Acute kidney injury (AKI) is a serious complication in critically ill patients admitted to the Intensive Care Unit (ICU). We hypothesized that ICU survivors with AKI would have a worse health-related quality of life (HRQOL) outcome than ICU survivors without AKI.

Methods

We performed a long-term prospective observational study. Patients admitted for > 48 hours in a medical-surgical ICU were included and divided in two groups: patients who fulfilled RIFLE criteria for AKI and patients without AKI. We used the Short-Form 36 to evaluate HRQOL before admission (by proxy within 48 hours after admission of the patient), at ICU discharge, hospital discharge, 3 and 6 months following ICU discharge (all by patients). Recovery in HRQOL from ICU-admission onwards was assessed using linear mixed modelling.

Results

Between September 2000 and January 2007 all admissions were screened for study participation. We included a total of 749 patients. At six months after ICU discharge 73 patients with AKI and 325 patients without AKI could be evaluated. In survivors with and without AKI, the pre-admission HRQOL (by proxy) and at six months after ICU discharge was significantly lower compared with an age matched general population. Most SF-36 dimensions changed significantly over time from ICU discharge. Change over time of HRQOL between the different AKI Rifle classes (Risk, Injury, Failure) showed no significant differences. At ICU discharge, scores were lowest in the group with AKI compared with the group without AKI for the physical functioning, role-physical and general health dimensions. However, there were almost no differences in HRQOL between both groups at six months.

Conclusions

The pre-admission HRQOL (by proxy) of AKI survivors was significantly lower in two dimensions compared with the age matched general population. Six months after ICU discharge survivors with and without AKI showed an almost similar HRQOL. However, compared with the general population with a similar age, HRQOL was poorer in both groups.
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Literature
1.
Hoste EA, Clermont G, Kersten A, Venkataraman R, Angus DC, De Bacquer D, Kellum JA: RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis. Crit Care 2006, 10: R73. 10.1186/cc4915PubMedCentralCrossRefPubMed
2.
Maynard SE, Whittle J, Chelluri L, Arnold R: Quality of life and dialysis decisions in critically ill patients with acute renal failure. Intensive Care Med 2003, 29: 1589-1593. 10.1007/s00134-003-1837-5CrossRefPubMed
3.
Korkeila M, Ruokonen E, Takala J: Costs of care, long-term prognosis and quality of life in patients requiring renal replacement therapy during intensive care. Intensive Care Med 2000, 26: 1824-1831. 10.1007/s001340000726CrossRefPubMed
4.
Hamel MB, Phillips RS, Davis RB, Desbiens N, Connors AF Jr, Teno JM, Wenger N, Lynn J, Wu AW, Fulkerson W, Tsevat J: Outcomes and cost-effectiveness of initiating dialysis and continuing aggressive care in seriously ill hospitalized adults. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments. Ann Intern Med 1997, 127: 195-202.CrossRefPubMed
5.
Ahlstrom A, Tallgren M, Peltonen S, Rasanen P, Pettila V: Survival and quality of life of patients requiring acute renal replacement therapy. Intensive Care Med 2005, 31: 1222-1228. 10.1007/s00134-005-2681-6CrossRefPubMed
6.
Gopal I, Bhonagiri S, Ronco C, Bellomo R: Out of hospital outcome and quality of life in survivors of combined acute multiple organ and renal failure treated with continuous venovenous hemofiltration/hemodiafiltration. Intensive Care Med 1997, 23: 766-772. 10.1007/s001340050407CrossRefPubMed
7.
Morgera S, Kraft AK, Siebert G, Luft FC, Neumayer HH: Long-term outcomes in acute renal failure patients treated with continuous renal replacement therapies. Am J Kidney Dis 2002, 40: 275-279. 10.1053/ajkd.2002.34505CrossRefPubMed
8.
Noble JS, Simpson K, Allison ME: Long-term quality of life and hospital mortality in patients treated with intermittent or continuous hemodialysis for acute renal and respiratory failure. Ren Fail 2006, 28: 323-330. 10.1080/08860220600591487CrossRefPubMed
9.
Graf J, Koch M, Dujardin R, Kersten A, Janssens U: Health-related quality of life before, 1 month after, and 9 months after intensive care in medical cardiovascular and pulmonary patients. Crit Care Med 2003, 31: 2163-2169. 10.1097/01.CCM.0000079607.87009.3ACrossRefPubMed
10.
Konopad E, Noseworthy TW, Johnston R, Shustack A, Grace M: Quality of life measures before and one year after admission to an intensive care unit. Crit Care Med 1995, 23: 1653-1659. 10.1097/00003246-199510000-00008CrossRefPubMed
11.
Wehler M, Geise A, Hadzionerovic D, Aljukic E, Reulbach U, Hahn EG, Strauss R: Health-related quality of life of patients with multiple organ dysfunction: individual changes and comparison with normative population. Crit Care Med 2003, 31: 1094-1101. 10.1097/01.CCM.0000059642.97686.8BCrossRefPubMed
12.
Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P: Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004, 8: R204-R212. 10.1186/cc2872PubMedCentralCrossRefPubMed
13.
National Kidney Foundation: K/DOQI clinical practice guidelines for chronic kidney disease evaluation, classification, and stratification. Am J Kidney Dis 2002, 39: S1-266.
14.
Knaus WA, Draper EA, Wagner DP, Zimmerman JE: APACHE II: a severity of disease classification system. Crit Care Med 1985, 13: 818-829. 10.1097/00003246-198510000-00009CrossRefPubMed
15.
Ware JE Jr, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992, 30: 473-483. 10.1097/00005650-199206000-00002CrossRefPubMed
16.
Ware JE: Health Survey Manual and Interpretation Guide. Boston: Medical Outcomes Trust; 1993.
17.
Ware JE, Kosinski M: Interpreting SF-36 summary health measures: a response. Qual Life Res 2001, 10: 405-413. 10.1023/A:1012588218728CrossRefPubMed
18.
Brazier JE, Harper R, Jones NM, O'Cathain A, Thomas KJ, Usherwood T, Westlake L: Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ 1992, 305: 160-164. 10.1136/bmj.305.6846.160PubMedCentralCrossRefPubMed
19.
Jenkinson C, Coulter A, Wright L: Short form 36 (SF36) health survey questionnaire: normative data for adults of working age. BMJ 1993, 306: 1437-1440. 10.1136/bmj.306.6890.1437PubMedCentralCrossRefPubMed
20.
Chrispin PS, Scotton H, Rogers J, Lloyd D, Ridley SA: Short Form 36 in the intensive care unit: assessment of acceptability, reliability and validity of the questionnaire. Anaesthesia 1997, 52: 15-23. 10.1111/j.1365-2044.1997.015-az014.xCrossRefPubMed
21.
Heyland DK, Hopman W, Coo H, Tranmer J, McColl MA: Long-term health-related quality of life in survivors of sepsis. Short Form 36: a valid and reliable measure of health-related quality of life. Crit Care Med 2000, 28: 3599-3605. 10.1097/00003246-200011000-00006CrossRefPubMed
22.
Aaronson NK, Muller M, Cohen PD, Essink-Bot ML, Fekkes M, Sanderman R, Sprangers MA, te Velde A, Verrips E: Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol 1998, 51: 1055-1068. 10.1016/S0895-4356(98)00097-3CrossRefPubMed
23.
Hofhuis J, Hautvast JL, Schrijvers AJ, Bakker J: Quality of life on admission to the intensive care: can we query the relatives? Intensive Care Med 2003, 29: 974-979.PubMed
24.
Hofhuis JG, Dijkgraaf MG, Hovingh A, Braam RL, van de Braak L, Spronk PE, Rommes JH: The Academic Medical Center Linear Disability Score for evaluation of physical reserve on admission to the ICU: can we query the relatives? Crit Care 2011, 15: R212. 10.1186/cc10447PubMedCentralCrossRefPubMed
25.
Twisk JWR: Applied Longitudinal Data Analysis for Epidemiology. Cambridge: Cambridge University Press; 2003.
26.
Cohen J: Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.
27.
Bagshaw SM, Laupland KB, Doig CJ, Mortis G, Fick GH, Mucenski M, Godinez-Luna T, Svenson LW, Rosenal T: Prognosis for long-term survival and renal recovery in critically ill patients with severe acute renal failure: a population-based study. Crit Care 2005, 9: R700-R709. 10.1186/cc3879PubMedCentralCrossRefPubMed
28.
Chertow GM, Christiansen CL, Cleary PD, Munro C, Lazarus JM: Prognostic stratification in critically ill patients with acute renal failure requiring dialysis. Arch Intern Med 1995, 155: 1505-1511. 10.1001/archinte.1995.00430140075007CrossRefPubMed
29.
Bellomo R, Farmer M, Boyce N: Combined acute respiratory and renal failure: management by continuous hemodiafiltration. Resuscitation 1994, 28: 123-131. 10.1016/0300-9572(94)90084-1CrossRefPubMed
30.
Schaefer JH, Jochimsen F, Keller F, Wegscheider K, Distler A: Outcome prediction of acute renal failure in medical intensive care. Intensive Care Med 1991, 17: 19-24. 10.1007/BF01708404CrossRefPubMed
31.
Spiegel DM, Ullian ME, Zerbe GO, Berl T: Determinants of survival and recovery in acute renal failure patients dialyzed in intensive-care units. Am J Nephrol 1991, 11: 44-47. 10.1159/000168271CrossRefPubMed
32.
Bagshaw SM, George C, Dinu I, Bellomo R: A multi-centre evaluation of the RIFLE criteria for early acute kidney injury in critically ill patients. Nephrol Dial Transplant 2008, 23: 1203-1210.CrossRefPubMed
33.
Gammelager H, Christiansen CF, Johansen MB, Tonnesen E, Jespersen B, Sorensen HT: One-year mortality among Danish intensive care patients with acute kidney injury: a cohort study. Crit Care 2012, 16: R124. 10.1186/cc11420PubMedCentralCrossRefPubMed
34.
Hofhuis JG, Spronk PE, van Stel HF, Schrijvers GJ, Rommes JH, Bakker J: The impact of critical illness on perceived health-related quality of life during ICU treatment, hospital stay, and after hospital discharge: a long-term follow-up study. Chest 2008, 133: 377-385. 10.1378/chest.07-1217CrossRefPubMed
35.
Druml W: Long term prognosis of patients with acute renal failure: is intensive care worth it? Intensive Care Med 2005, 31: 1145-1147. 10.1007/s00134-005-2682-5CrossRefPubMed
36.
Rogers J, Ridley S, Chrispin P, Scotton H, Lloyd D: Reliability of the next of kins' estimates of critically ill patients' quality of life. Anaesthesia 1997, 52: 1137-1143. 10.1111/j.1365-2044.1997.240-az0374.xCrossRefPubMed
37.
Scales DC, Tansey CM, Matte A, Herridge MS: Difference in reported pre-morbid health-related quality of life between ARDS survivors and their substitute decision makers. Intensive Care Med 2006, 32: 1826-1831. 10.1007/s00134-006-0333-0CrossRefPubMed
38.
Orwelius L, Nordlund A, Nordlund P, Simonsson E, Backman C, Samuelsson A, Sjoberg F: Pre-existing disease: the most important factor for health related quality of life long-term after critical illness: a prospective, longitudinal, multicentre trial. Crit Care 2010, 14: R67. 10.1186/cc8967PubMedCentralCrossRefPubMed
39.
Delannoy B, Floccard B, Thiolliere F, Kaaki M, Badet M, Rosselli S, Ber CE, Saez A, Flandreau G, Guerin C: Six-month outcome in acute kidney injury requiring renal replacement therapy in the ICU: a multicentre prospective study. Intensive Care Med 2009, 35: 1907-1915. 10.1007/s00134-009-1588-zCrossRefPubMed
40.
Sprangers MA, Schwartz CE: Integrating response shift into health-related quality of life research: a theoretical model. Soc Sci Med 1999, 48: 1507-1515. 10.1016/S0277-9536(99)00045-3CrossRefPubMed
Metadata
Title
The effect of acute kidney injury on long-term health-related quality of life: a prospective follow-up study
Authors
José GM Hofhuis
Henk F van Stel
Augustinus JP Schrijvers
Johannes H Rommes
Peter E Spronk
Publication date
01-02-2013
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2013
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc12491

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