Quality of life was commonly lower in patients on dialysis (36-Item Short Form Health Survey Mental Component Summary 45.7 SF-36 Physical Component Summary 35.5 91 studies, 32,105 participants for MCS and PCS) than in other CKD populations (patients not on RRT: SF-36 MCS 66.6, p = 0.002 PCS 66.3, p = 0.002 39 studies, 24,600 participants transplant: MCS 50.0, p = 0.002 PCS 48.0, p = 0.002 39 studies, 9,664 participants). A number of symptoms were significantly ( p < 0.05 after adjustment for multiple testing) less prevalent and/or less severe within the post-transplantation population, which may suggest attribution to CKD (fatigue, depression, itching, poor mobility, poor sleep, and dry mouth). Random effects meta-analyses highlighted the considerable symptom and HRQOL burden associated with CKD, with fatigue particularly prevalent, both in patients not on RRT (14 studies, 4,139 participants: 70%, 95% CI 60%–79%) and those receiving dialysis (21 studies, 2,943 participants: 70%, 95% CI 64%–76%). Studies used 67 different symptom and HRQOL outcome measures, which provided data on 68 reported symptoms. The search identified 1,529 studies, of which 449, with 199,147 participants from 62 countries, were included in the analysis. Methodological quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data, and an exploration of publication bias performed.
Random effects meta-analyses were used to pool data, stratified by CKD group: not on RRT, receiving dialysis, or in receipt of a kidney transplant.
MEDLINE, PsycINFO, and CINAHL were searched for English-language cross-sectional/longitudinal studies reporting prevalence and/or severity of symptoms and/or HRQOL in CKD, published between January 2000 and September 2021, including adult patients with CKD, and measuring symptom prevalence/severity and/or HRQOL using a patient-reported outcome measure (PROM).
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