Skip to main content

Advertisement

Log in

Health-related quality-of-life among survivors of acute kidney injury in the intensive care unit: a systematic review

  • Systematic Review
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

Purpose

To summarize evidence on long-term health-related quality-of-life (HRQL) among survivors of acute kidney injury (AKI) in the intensive care unit (ICU).

Methods

We performed a comprehensive search of the literature for studies reporting original data describing HRQL utilizing validated instruments. Search, study selection and data abstraction were performed in duplicate. Study quality was appraised. Due to study heterogeneity, data are primarily summarized qualitatively.

Results

Our search yielded 2193 articles of which 18 were selected for detailed analysis. The quality of these 18 studies was generally good. Numerous HRQL instruments were utilized, and assessment occurred at variable follow-up duration (range 2 months to 14.5 years). HRQL among AKI survivors was reduced when compared to age/sex-matched populations. HRQL among survivors with and without AKI was generally described as similar beyond 6 months. Physical component domains were consistently more impaired than mental component domains. Survivors had considerable limitations in activities of daily living, implying newly acquired disability, with few returning to work. Despite diminished HRQL, patients’ HRQL was generally perceived as satisfactory, and the majority would receive similar treatment again, including renal replacement therapy in the ICU, if necessary.

Conclusions

Among survivors of critical illness complicated by AKI, HRQL was impaired when referenced to population norms, but it was not significantly different from that of survivors without AKI. Physical limitations and disabilities were more commonly exhibited by AKI patients. Importantly, the impaired HRQL was generally perceived as acceptable to patients, most of whom expressed willingness to undergo similar treatment in the future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Bouchard J, Acharya A, Cerda J, Maccariello ER, Madarasu RC, Tolwani AJ, Liang X, Fu P, Liu ZH, Mehta RL (2015) A prospective international multicenter study of AKI in the intensive care unit. Clin J Am Soc Nephrol 10:1324–1331

    Article  PubMed  Google Scholar 

  2. Hoste EA, Bagshaw SM, Bellomo R, Cely CM, Colman R, Cruz DN, Edipidis K, Forni LG, Gomersall CD, Govil D, Honore PM, Joannes-Boyau O, Joannidis M, Korhonen AM, Lavrentieva A, Mehta RL, Palevsky P, Roessler E, Ronco C, Uchino S, Vazquez JA, Vidal Andrade E, Webb S, Kellum JA (2015) Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Intensive Care Med 41:1411–1423

    Article  PubMed  Google Scholar 

  3. Chawla LS, Eggers PW, Star RA, Kimmel PL (2014) Acute kidney injury and chronic kidney disease as interconnected syndromes. N Engl J Med 371:58–66

    Article  PubMed  Google Scholar 

  4. Gammelager H, Christiansen CF, Johansen MB, Tonnesen E, Jespersen B, Sorensen HT (2014) Three-year risk of cardiovascular disease among intensive care patients with acute kidney injury: a population-based cohort study. Crit Care 18:492

    Article  PubMed Central  PubMed  Google Scholar 

  5. Lai TS, Wang CY, Pan SC, Huang TM, Lin MC, Lai CF, Wu CH, Wu VC, Chien KL, National Taiwan University Hospital Study Group on Acute Renal Failure (2013) Risk of developing severe sepsis after acute kidney injury: a population-based cohort study. Crit Care 17:R231

    Article  PubMed Central  PubMed  Google Scholar 

  6. Wang WJ, Chao CT, Huang YC, Wang CY, Chang CH, Huang TM, Lai CF, Huang HY, Shiao CC, Chu TS, Chen YM, Wu VC, Ko WJ, Wu KD, National Taiwan University Study Group on Acute Renal F (2014) The impact of acute kidney injury with temporary dialysis on the risk of fracture. J Bone Miner Res 29:676–684

    Article  PubMed  Google Scholar 

  7. Wu VC, Wu PC, Wu CH, Huang TM, Chang CH, Tsai PR, Ko WJ, Chen L, Wang CY, Chu TS, Wu KD, National Taiwan University Study Group on Acute Renal Failure G (2014) The impact of acute kidney injury on the long-term risk of stroke. J Am Heart Assoc 3:e000933

  8. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339:b2700

    Article  PubMed Central  PubMed  Google Scholar 

  9. Downs SH, Black N (1998) The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health 52:377–384

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Oeyen S, De Corte W, Benoit D, Annemans L, Dhondt A, Vanholder R, Decruyenaere J, Hoste E (2015) Long-term quality of life in critically ill patients with acute kidney injury treated with renal replacement therapy: a matched cohort study. Crit Care 19:289

    Article  PubMed Central  PubMed  Google Scholar 

  11. Wang AY, Bellomo R, Cass A, Finfer S, Gattas D, Myburgh J, Chadban S, Hirakawa Y, Ninomiya T, Li Q, Lo S, Barzi F, Sukkar L, Jardine M, Gallagher MP, Investigators P-RS, the ACTG (2015) Health-related quality of life in survivors of acute kidney injury: the prolonged outcomes study of the randomized evaluation of normal versus augmented level replacement therapy study outcomes. Nephrology 20:492–498

    Article  PubMed  Google Scholar 

  12. Abelha FJ, Botelho M, Fernandes V, Barros H (2009) Outcome and quality of life of patients with acute kidney injury after major surgery. Nefrologia 29:404–414

    CAS  PubMed  Google Scholar 

  13. Delannoy B, Floccard B, Thiolliere F, Kaaki M, Badet M, Rosselli S, Ber CE, Saez A, Flandreau G, Guerin C (2009) Six-month outcome in acute kidney injury requiring renal replacement therapy in the ICU: a multicentre prospective study. Intensive Care Med 35:1907–1915

    Article  CAS  PubMed  Google Scholar 

  14. Hofhuis JG, van Stel HF, Schrijvers AJ, Rommes JH, Spronk PE (2013) The effect of acute kidney injury on long-term health-related quality of life: a prospective follow-up study. Crit Care 17:R17

    Article  PubMed Central  PubMed  Google Scholar 

  15. Maynard SE, Whittle J, Chelluri L, Arnold R (2003) Quality of life and dialysis decisions in critically ill patients with acute renal failure. Intensive Care Med 29:1589–1593

    Article  PubMed  Google Scholar 

  16. Morsch C, Thome FS, Balbinotto A, Guimaraes JF, Barros EG (2011) Health-related quality of life and dialysis dependence in critically ill patient survivors of acute kidney injury. Ren Fail 33:949–956

    Article  PubMed  Google Scholar 

  17. Noble JS, Simpson K, Allison ME (2006) Long-term quality of life and hospital mortality in patients treated with intermittent or continuous hemodialysis for acute renal and respiratory failure. Ren Fail 28:323–330

    Article  PubMed  Google Scholar 

  18. Van Berendoncks AM, Elseviers MM, Lins RL, Group SS (2010) Outcome of acute kidney injury with different treatment options: long-term follow-up. Clin J Am Soc Nephrol 5:1755–1762

    Article  PubMed Central  PubMed  Google Scholar 

  19. Ahlstrom A, Tallgren M, Peltonen S, Rasanen P, Pettila V (2005) Survival and quality of life of patients requiring acute renal replacement therapy. Intensive Care Med 31:1222–1228

    Article  PubMed  Google Scholar 

  20. Gallagher M, Cass A, Bellomo R, Finfer S, Gattas D, Lee J, Lo S, McGuinness S, Myburgh J, Parke R, Rajbhandari D, Investigators P-RS, the ACTG (2014) Long-term survival and dialysis dependency following acute kidney injury in intensive care: extended follow-up of a randomized controlled trial. PLoS Med 11:e1001601

    Article  PubMed Central  PubMed  Google Scholar 

  21. Nisula S, Vaara ST, Kaukonen KM, Reinikainen M, Koivisto SP, Inkinen O, Poukkanen M, Tiainen P, Pettila V, Korhonen AM, Group F-QS (2013) Six-month survival and quality of life of intensive care patients with acute kidney injury. Crit Care 17:R250

    Article  PubMed Central  PubMed  Google Scholar 

  22. Vaara ST, Pettila V, Reinikainen M, Kaukonen KM, Finnish Intensive Care C (2012) Population-based incidence, mortality and quality of life in critically ill patients treated with renal replacement therapy: a nationwide retrospective cohort study in Finnish intensive care units. Crit Care 16:R13

    Article  PubMed Central  PubMed  Google Scholar 

  23. Gopal I, Bhonagiri S, Ronco C, Bellomo R (1997) Out of hospital outcome and quality of life in survivors of combined acute multiple organ and renal failure treated with continuous venovenous hemofiltration/hemodiafiltration. Intensive Care Med 23:766–772

    Article  CAS  PubMed  Google Scholar 

  24. Korkeila M, Ruokonen E, Takala J (2000) Costs of care, long-term prognosis and quality of life in patients requiring renal replacement therapy during intensive care. Intensive Care Med 26:1824–1831

    Article  CAS  PubMed  Google Scholar 

  25. Morgera S, Kraft AK, Siebert G, Luft FC, Neumayer HH (2002) Long-term outcomes in acute renal failure patients treated with continuous renal replacement therapies. Am J Kidney Dis 40:275–279

    Article  PubMed  Google Scholar 

  26. Johansen KL, Smith MW, Unruh ML, Siroka AM, O’Connor TZ, Palevsky PM, Network VNARFT (2010) Predictors of health utility among 60-day survivors of acute kidney injury in the Veterans affairs/national institutes of health acute renal failure trial network study. Clin J Am Soc Nephrol 5:1366–1372

    Article  PubMed Central  PubMed  Google Scholar 

  27. Landoni G, Zangrillo A, Franco A, Aletti G, Roberti A, Calabro MG, Slaviero G, Bignami E, Marino G (2006) Long-term outcome of patients who require renal replacement therapy after cardiac surgery. Eur J Anaesthesiol 23:17–22

    CAS  PubMed  Google Scholar 

  28. Myhren H, Ekeberg O, Stokland O (2010) Health-related quality of life and return to work after critical illness in general intensive care unit patients: a 1-year follow-up study. Crit Care Med 38:1554–1561

    Article  PubMed  Google Scholar 

  29. Dinglas VD, Gifford JM, Husain N, Colantuoni E, Needham DM (2013) Quality of life before intensive care using EQ-5D: patient versus proxy responses. Crit Care Med 41:9–14

    Article  PubMed Central  PubMed  Google Scholar 

  30. Evans RW, Manninen DL, Garrison LP Jr, Hart LG, Blagg CR, Gutman RA, Hull AR, Lowrie EG (1985) The quality of life of patients with end-stage renal disease. N Engl J Med 312:553–559

    Article  CAS  PubMed  Google Scholar 

  31. Weisbord SD, Carmody SS, Bruns FJ, Rotondi AJ, Cohen LM, Zeidel ML, Arnold RM (2003) Symptom burden, quality of life, advance care planning and the potential value of palliative care in severely ill haemodialysis patients. Nephrol Dial Transplant 18:1345–1352

    Article  PubMed  Google Scholar 

  32. Sacket DL, Richardson WS, Rosenberg W (1997) Evidence-based medicine: how to practice and teach EBM. Churchill Livingstone, New York

Download references

Acknowledgments

S.M. Bagshaw is supported by a Canada Research Chair in Critical Care Nephrology.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sean M. Bagshaw.

Ethics declarations

Conflicts of interest

S.M. Bagshaw has consulted for and received speaking fees and unrestricted grants from Baxter. The other authors declare that they have no conflicts of interest.

Additional information

Take-home message: Health-related quality-of-life among survivors of acute kidney injury in the intensive care unit is lower than population norms but not significantly different from that of critically ill survivors without acute kidney injury.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 103 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Villeneuve, PM., Clark, E.G., Sikora, L. et al. Health-related quality-of-life among survivors of acute kidney injury in the intensive care unit: a systematic review. Intensive Care Med 42, 137–146 (2016). https://doi.org/10.1007/s00134-015-4151-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00134-015-4151-0

Keywords

Navigation