Related Experiment Video
Updated: May 1, 2026
5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
Published on: April 4, 2025
Quality of life and outcomes in African Americans with CKD
Anna Porter1, Michael J Fischer2, Xuelei Wang3
1Department of Medicine, University of Illinois Hospital and Health Sciences System and Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois; aporte3@uic.edu.
Insights
Low health-related quality of life (HRQOL) is linked to worse outcomes in patients with hypertensive chronic kidney disease (CKD). Lower physical and mental health scores predict increased cardiovascular events and kidney disease progression.
Area of Science:
- Nephrology
- Public Health
- Cardiovascular Medicine
Background:
- Low health-related quality of life (HRQOL) is a known risk factor for adverse outcomes in end-stage renal disease (ESRD).
- The association between HRQOL and outcomes in predialysis chronic kidney disease (CKD) remains less understood.
- Hypertensive CKD disproportionately affects African Americans, highlighting the need for research in this population.
Purpose of the Study:
- To evaluate the association between HRQOL and renal and cardiovascular (CV) outcomes in African Americans with hypertensive CKD.
- To investigate the impact of both physical and mental health composite scores on disease progression and mortality.
- To analyze these associations using various measurement approaches (baseline, time-varying, cumulative).
Main Methods:
- Utilized data from 1091 African Americans in the African American Study of Kidney Disease and Hypertension (AASK) trial and cohort studies.
- Assessed HRQOL using the Short Form-36 survey, focusing on mental health composite (MHC) and physical health composite (PHC) scores.
- Employed Cox regression analyses to examine the relationship between decrements in MHC and PHC scores and outcomes like CKD progression, CV events, and all-cause mortality.
Main Results:
- Lower mean PHC scores were consistently associated with increased risk of CV events/CV death and CKD progression/death.
- Lower mean MHC scores were associated with an elevated risk of CV events/CV death across all analytical methods.
- Time-varying and cumulative decrements in both PHC and MHC scores were significantly linked to CKD progression and the composite outcome of CKD progression or death.
Conclusions:
- Diminished HRQOL, encompassing both physical and mental health, is significantly associated with adverse renal and cardiovascular outcomes in African Americans with hypertensive CKD.
- These findings underscore the importance of assessing and addressing HRQOL in managing patients with hypertensive CKD.
- Interventions aimed at improving HRQOL may play a crucial role in mitigating adverse outcomes in this high-risk population.
Abstract:
Low health-related quality of life (HRQOL) has been associated with increased risk for hospitalization and death in ESRD. However, the relationship of HRQOL with outcomes in predialysis CKD is not well understood. We evaluated the association between HRQOL and renal and cardiovascular (CV) outcomes in 1091 African Americans with hypertensive CKD enrolled in the African American Study of Kidney Disease and Hypertension (AASK) trial and cohort studies. Outcomes included CKD progression (doubling of serum creatinine/ESRD), CV events/CV death, and a composite of CKD progression or death from any cause (CKD progression/death). We assessed HRQOL, including mental health composite (MHC) and physical health composite (PHC), using the Short Form-36 survey. Cox regression analyses were used to assess the relationship between outcomes and five-point decrements in MHC and PHC scores using measurements at baseline, at the most recent annual visit (time-varying), or averaged from baseline to the most recent visit (cumulative). During approximately 10 years of follow-up, lower mean PHC score was associated with increased risk of CV events/CV death and CKD progression/death across all analytic approaches, but only time-varying and cumulative decrements were associated with CKD progression. Similarly, lower mean MHC score was associated with increased risk of CV events/CV death regardless of analytic approach, while only time-varying and cumulative decrements in mean MHC score was associated with CKD progression and CKD progression or death. In conclusion, lower HRQOL is associated with a range of adverse outcomes in African Americans with hypertensive CKD.
Related Concept Videos
01:28Chronic Kidney Disease III: Interprofessional Care
01:24Chronic Kidney Disease II: Clinical Manifestations
01:25Chronic Kidney Disease I: Introduction
01:18Chronic Kidney Disease IV: Nursing Management
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration