Abstract
INTRODUCTION AND AIMS: Young adults receiving renal replacement therapy (RRT) face additional challenges in life. The impact of renal failure on non-medical aspects of young adulthood is uncertain. We aimed to establish socio-demographic, psychological health and lifestyle outcomes for young adults on RRT byundertaking a systematic review of the literature and performing meta-analyses.
METHODS: We studied 16-30 year olds receiving RRT, compared with the general population. We selected randomised controlled trials, cohort or cross-sectional studies without language restriction. We extracted proportions of socio-demographic and lifestyle outcomes and quality of life scores assessed using validated psychological health tests.
RESULTS: We included 64 studies of 15635 participants. Articles were largely single centre cross-sectional studies of those transplanted in childhood. As shown above, compared to healthy peers, young adults on RRT had reduced quality of life, worse for dialysis patients (7 studies, standardised mean difference (SMD) -1.01, 95% confidence interval (CI) -1.32 to -0.70) compared to transplant (9 studies, SMD -0.42, CI -0.64 to -0.20). They were twice as likely to be unemployed (9 studies, relative risk (RR) 2.62, CI 2.19-3.13), to live in the family home (2 studies, RR 1.98, CI 1.45-2.71) and to abstain from alcohol (3 studies, RR 2.07, CI 1.10-3.92). They were half as likely to be married or have a partner (5 studies, RR 0.45, CI 0.35-0.57). Higher education (3 studies, RR 1.05, CI 0.73-1.51) and smoking rates (2 studies, RR 0.69, CI 0.38-1.25) did not differ. The data synthesis is limited by high heterogeneity and study bias towards surviving patients; in addition, the proportions do not consider patients’ current modality.
CONCLUSIONS: Established renal failure is associated with worse quality of life in young people and limited employment, independence and relationships compared to healthy peers. Routine prospective data collection is needed to raise clinical awareness of outcomes vital for patients.
METHODS: We studied 16-30 year olds receiving RRT, compared with the general population. We selected randomised controlled trials, cohort or cross-sectional studies without language restriction. We extracted proportions of socio-demographic and lifestyle outcomes and quality of life scores assessed using validated psychological health tests.
RESULTS: We included 64 studies of 15635 participants. Articles were largely single centre cross-sectional studies of those transplanted in childhood. As shown above, compared to healthy peers, young adults on RRT had reduced quality of life, worse for dialysis patients (7 studies, standardised mean difference (SMD) -1.01, 95% confidence interval (CI) -1.32 to -0.70) compared to transplant (9 studies, SMD -0.42, CI -0.64 to -0.20). They were twice as likely to be unemployed (9 studies, relative risk (RR) 2.62, CI 2.19-3.13), to live in the family home (2 studies, RR 1.98, CI 1.45-2.71) and to abstain from alcohol (3 studies, RR 2.07, CI 1.10-3.92). They were half as likely to be married or have a partner (5 studies, RR 0.45, CI 0.35-0.57). Higher education (3 studies, RR 1.05, CI 0.73-1.51) and smoking rates (2 studies, RR 0.69, CI 0.38-1.25) did not differ. The data synthesis is limited by high heterogeneity and study bias towards surviving patients; in addition, the proportions do not consider patients’ current modality.
CONCLUSIONS: Established renal failure is associated with worse quality of life in young people and limited employment, independence and relationships compared to healthy peers. Routine prospective data collection is needed to raise clinical awareness of outcomes vital for patients.
| Original language | English |
|---|---|
| Article number | SO008 |
| Pages (from-to) | iii5. |
| Number of pages | 1 |
| Journal | Nephrology Dialysis Transplantation |
| Volume | 32 |
| Issue number | Suppl 3 |
| Early online date | 26 May 2017 |
| DOIs | |
| Publication status | Published - May 2017 |
| Event | ERA-EDTA 54th Annual Congress - Spain, Madrid Duration: 3 Jun 2017 → 6 Jun 2017 http://www.era-edta2017.org/en-US/home |
Bibliographical note
Conference abstract only.Special issue: Proceedings of the 54th ERA-EDTA Congress, Royal Palace, Madrid, Spain 3–6 June 2017