Research Article: Association between vitamin D deficiency and health-related quality of life in patients with chronic kidney disease from the KNOW-CKD study

Date Published: April 27, 2017

Publisher: Public Library of Science

Author(s): Tae Ryom Oh, Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, Seung Hyeok Han, Su-Ah Sung, Kyubeck Lee, Kook Hwan Oh, Curie Ahn, Soo Wan Kim, Andrzej T Slominski.


Vitamin D deficiency is a growing health problem in both the general population and in patients with chronic kidney disease (CKD). However, the relationship between serum 25-hydroxyvitamin D levels and health-related quality of life in CKD is not well established. This study examined the association between vitamin D deficiency and quality of life in pre-dialysis CKD patients. Serum 25-hydroxyvitamin D levels and the Korean version of the Kidney Disease Quality of Life short form were obtained for 1844 pre-dialysis CKD patients in the prospective KoreaN cohort Study for Outcomes in patients With Chronic Kidney Disease (KNOW-CKD). The baseline estimated glomerular filtration rate was 50.26 ± 0.71 mL/min/1.73 m2. We identified 1294 (70.2%) patients with vitamin D deficiency, defined as a 25-hydroxyvitamin D level < 20 ng/ml. The scores of the kidney disease component summary, physical component summary, and mental component summary in the vitamin D deficiency group were significantly lower compared to the scores of those without vitamin D deficiency. The serum 25-hydroxyvitamin D level was independently associated with the kidney disease component summary and mental component summary scores (β = 0.147, p = 0.003 and β = 0.151, p = 0.047). In conclusion, there was a significant association between serum 25-hydroxyvitamin D levels and kidney disease component summary and mental component summary scores in pre-dialysis CKD patients.

Partial Text

Chronic kidney disease (CKD) is a major public health concern with rising prevalence. With advances in medicine, the life expectancy of CKD patients has been increasing, and importantly, this has been paralleled by an improvement in patients’ quality of life (QOL). QOL refers to the general well-being of individuals, and covers a wide range of contexts including healthcare, employment, and politics, among others. Health-Related Quality of Life (HRQOL) is a related concept that focuses on the effects of illness, and specifically on the impact that treatment may have on QOL. It can help us make out the distinction between aspects of life related to health. A number of definitions have been proposed to explain the concept of HRQOL, and it has now been generally accepted that HRQOL represents the positive and negative aspects of patients’ symptoms, including emotional, social, cognitive functions, disease burden, and treatment side effects [1].

A quality of life assessment is critical to the holistic management of patients living with chronic diseases including CKD. Using data from the MDRD clinical trial, Rocco et al. [16] showed that decreased GFR in CKD patients was correlated with impaired quality of life assessed by the SF-36 health survey. Since then, many other studies have confirmed that physical function and viability affected patients’ quality of life, and that HRQOL was significantly reduced in ESRD patients when compared with the general population [17–19].




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