Quality of life of people with chronic kidney disease
Quality of life has no agreed definition but is often described in terms of subjective well-being and life satisfaction. When applied to health, it refers to the effects of disease, injury or treatments as perceived and reported by the individuals themselves (Morton and Webster 2014).
CKD can affect a person’s quality of life in many ways. Symptoms such as fatigue, fluid retention, bone pain, peripheral neuropathy or sleep disturbance as well as side effects from medication or kidney replacement therapy (KRT) can adversely affect daily living (Eranga Yapa et al. 2021). CKD diagnosis and progression may have an impact on mental health, most commonly through experiencing grief, anxiety or depression. Limitations on diet and travel for those on dialysis, satisfaction with care or unmet needs for information and support services, financial demands, and spiritual well-being can also affect quality of life.
Quality of life declines as a person’s kidney damage and loss of function increases (Morton and Webster 2014). Each stage of CKD from diagnosis – through decline of kidney function, KRT with dialysis or transplantation, to end-of-life care – can have a negative impact (Bonner et al. 2018). For some people with CKD, quality of life becomes a more important consideration than length of life, and they may decide to end their dialysis treatment in favour of end-of-life care.
In 2011–12, adults with biomedical signs of CKD were more likely to rate their health as fair/poor, than adults without biomedical signs of CKD (23% and 12%) (AIHW analysis of ABS 2013). CKD has a greater impact on the quality of life of younger people than older people (Francis et al. 2019, Tong et al. 2013). The combination of CKD and diabetes also has an adverse impact – people with both diseases have substantially poorer quality of life than those with only one of these diseases (Wyld et al. 2021).