Among elderly patients with advanced CNS, health-related quality of life (HRQOL) was found to be lower in women, while it declined more rapidly over time in men.
Until now, the effect of gender on the time course of HRQOL in renal patients was unknown. Therefore, in The European Quality Study on Treatment in Advanced Chronic Kidney Disease (EQUAL) this was investigated in 1421 patients (≥ 65 years) with advanced CNS (eGFR < 20 ml/min/1.73 m2) not on dialysis.
In the observational, prospective cohort study, HRQOL was measured every three to six months between 2012 and 2020 using the 36-Item Short Form Survey. The resulting Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were then analyzed with statistical linear-mixed models to determine the time course for men and women.
Based on 5345 measurements, women had a worse baseline HRQOL with significantly lower mean PCS (42) and MCS scores (60) than men (PCS score 55 and MCS score 69; p < 0.001). But after baseline, both the PCS and MCS scores declined about twice as fast in men as in women. For example, the PCS decreased in men by 2.5 points per year (95% CI 1.8-3.1) and in women by 1.1 (95% CI 0.1-2.0).
The difference was slightly attenuated when correcting for factors such as eGFR decline. Furthermore, especially in men – and to a lesser extent in women – higher serum phosphate concentrations, lower hemoglobin concentrations and pre-existing diabetes were associated with lower PCS and MCS scores.
Bron:
Chesnaye NC, Meuleman Y, de Rooij ENM, et al. Health-Related Quality-of-Life Trajectories over Time in Older Men and Women with Advanced Chronic Kidney Disease. Clin J Am Soc Nephrol 2022;17:205-14.