Skip to main content

Advertisement

SpringerLink
Log in

The impact of axial spondyloarthritis on quality of life (QoL): a comparison with the impact of moderate to end-stage chronic kidney disease on QoL

  • Brief Communication
  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

The purpose of the study was to assess the impact of axial spondyloarthritis (axSpA) on patients’ quality of life (QoL) compared to patients with moderate to end-stage chronic kidney disease (CKD).

Methods

We conducted secondary analysis of QoL data obtained from patients with axSpA and CKD from 2011 to 2014. QoL was assessed using the SF-36 version 2 and KDQoL-SF for patients with axSpA and CKD, respectively. Patients with CKD were subcategorized to CKD-pre-dialysis, hemodialysis (CKD-HD) and peritoneal dialysis (CKD-PD). Linear regression was used to compare QoL between patients with axSpA and CKD after adjusting for age, gender, ethnicity, education level, and marital status.

Results

A total of 765 patients (mean age 54.6, 63.0% males, 69.0% Chinese) were analyzed, of which 188 (24.5%) had axSpA. Patients with axSpA had poorer SF-36 bodily pain (BP) scores (axSpA: reference; CKD-pre-dialysis β: 11.04, p < 0.001; CKD-HD β: 9.52, p < 0.001; CKD-PD β: 10.35, p < 0.001) and higher general health scores (axSpA: reference; CKD-pre-dialysis β: − 7.87, p < 0.001; CKD-HD β: − 7.14, p < 0.001, CKD-PD β: − 7.25, p < 0.001) as compared to patients with CKD. Generally, patients with axSpA had poorer SF-36 scores than patients with CKD-pre-dialysis and similar SF-36 scores compared to patients with CKD-HD or CKD-PD.

Conclusions

The burden of axSpA on QoL is not trivial and is comparable to patients with CKD-HD or CKD-PD.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Megari, K. (2013). Quality of life in chronic disease patients. Health Psychology Research, 1(3), e27.

  2. Taurog, J. D., Chhabra, A., & Colbert, R. A. (2016). Ankylosing spondylitis and axial spondyloarthritis. New England Journal of Medicine, 374(26), 2563–2574.

    Article  PubMed  Google Scholar 

  3. Wee, H. L., Seng, B. J., Lee, J. J., Chong, K. J., Tyagi, P., Vathsala, A., & How, P. (2016). Association of anemia and mineral and bone disorder with health-related quality of life in Asian pre-dialysis patients. Health and Quality of Life Outcomes, 14, 94.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Cleary, J., & Drennan, J. (2005). Quality of life of patients on haemodialysis for end-stage renal disease. Journal of Advanced Nursing, 51(6), 577–586.

    Article  PubMed  Google Scholar 

  5. Hill, N. R., Fatoba, S. T., Oke, J. L., Hirst, J. A., O’Callaghan, C. A., Lasserson, D. S., & Hobbs, F. D. R. (2016). Global prevalence of chronic kidney disease—A systematic review and meta-analysis. PLoS ONE, 11(7), e0158765.

  6. Levey, A. S., & Coresh, J. (2012). Chronic kidney disease. The Lancet, 379(9811), 165–180.

    Article  Google Scholar 

  7. Stevens, P. E., Levin, A., & for the Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group (2013). Evaluation and management of chronic kidney disease: Synopsis of the kidney disease: Improving global outcomes 2012 clinical practice guideline. Annals of Internal Medicine, 158(11), 825–830.

    Article  PubMed  Google Scholar 

  8. Ward, M. M., Deodhar, A., Akl, E. A., Lui, A., Ermann, J., Gensler, L. S., Smith, J. A., Borenstein, D., Hiratzka, J., Weiss, P. F., Inman, R. D., Majithia, V., Haroon, N., Maksymowych, W. P., Joyce, J., Clark, B. M., Colbert, R. A., Figgie, M. P., Hallegua, D. S., Prete, P. E., Rosenbaum, J. T., Stebulis, J. A., Bosch, F. v. d, Yu, D. T. Y., Miller, A. S., Reveille, J. D., & Caplan, L. (2016). American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis and Rheumatology, 68(2), 282–298.

    Article  PubMed  Google Scholar 

  9. Braun, J., & Sieper, J. (2007). Ankylosing spondylitis. The Lancet, 369(9570), 1379–1390.

    Article  Google Scholar 

  10. Muñoz-Fernández, S., García-Aparicio, A. M., Hidalgo, M. V., Platero, M., Schlincker, A., Bascones, M. L., Pombo, M., Morente, P., Sanpedro, J., & Martín-Mola, E. (2008). Methotrexate: An option for preventing the recurrence of acute anterior uveitis. Eye, 23, 1130.

    Article  PubMed  CAS  Google Scholar 

  11. Sieper, J., Rudwaleit, M., Baraliakos, X., Brandt, J., Braun, J., Burgos-Vargas, R., Dougados, M., Hermann, K. G., Landewe, R., Maksymowych, W., & van der Heijde, D. (2009). The Assessment of SpondyloArthritis International Society (ASAS) handbook: A guide to assess spondyloarthritis. Annals of the Rheumatic Diseases, 68(Suppl 2), ii1–ii44.

    Article  PubMed  Google Scholar 

  12. Chuang, S. H., Wong, H. C., Vathsala, A., Lee, E., & How, P. P. (2016). Prevalence of chronic kidney disease-mineral and bone disorder in incident peritoneal dialysis patients and its association with short-term outcomes. Singapore Medical Journal, 57(11), 603–609.

    Article  PubMed  PubMed Central  Google Scholar 

  13. van Lunteren, M., Scharloo, M., Ez-Zaitouni, Z., de Koning, A., Landewé, R., Ramonda, R., Kaptein, A. A., van Gaalen, F. A., & van der Heijde, D. (2018). The impact of illness perceptions and coping on the association between back pain and health outcomes in patients suspected of axial spondyloarthritis: Data from the SPACE cohort. Arthritis Care and Research. https://doi.org/10.1002/acr.23566.

  14. Teasdale, E. J., Leydon, G., Fraser, S., Roderick, P., Taal, M. W., & Tonkin-Crine, S. (2017). Patients’ experiences after CKD diagnosis: A meta-ethnographic study and systematic review. American Journal of Kidney Diseases, 70(5), 656–665.

    Article  PubMed  Google Scholar 

  15. Aktekin, L. A., Eser, F., Malhan, S., Oksuz, E., Keskin, D., & Bodur, H. (2009). A comparison of four different HRQoL generic questionnaire in five different patient groups. Rheumatology International, 30(1), 63–67.

    Article  PubMed  Google Scholar 

  16. Wang, J., Wang, Y., Wang, L. B., Xu, H., & Zhang, X. L. (2012). A comparison of quality of life in adolescents with epilepsy or asthma using the Short-Form Health Survey (SF-36). Epilepsy Research, 101(1–2), 157–165.

    Article  PubMed  Google Scholar 

  17. Sathvik, B. S., Parthasarathi, G., Narahari, M. G., & Gurudev, K. C. (2008). An assessment of the quality of life in hemodialysis patients using the WHOQOL-BREF questionnaire. Indian Journal of Nephrology, 18(4), 141–149.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  18. Kwan, Y. H., Fong, W. W., Lui, N. L., Yong, S. T., Cheung, Y. B., Malhotra, R., Ostbye, T., & Thumboo, J. (2016). Validity and reliability of the Short Form 36 Health Surveys (SF-36) among patients with spondyloarthritis in Singapore. Rheumatology International, 36(12), 1759–1765.

    Article  PubMed  Google Scholar 

  19. Wee, H. L., Cheung, Y. B., Li, S. C., Fong, K. Y., & Thumboo, J. (2005). The impact of diabetes mellitus and other chronic medical conditions on health-related Quality of Life: Is the whole greater than the sum of its parts? Health and Quality of Life Outcomes, 3, 2.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Rudwaleit, M., van der Heijde, D., Landewe, R., Listing, J., Akkoc, N., Brandt, J., Braun, J., Chou, C. T., Collantes-Estevez, E., Dougados, M., Huang, F., Gu, J., Khan, M. A., Kirazli, Y., Maksymowych, W. P., Mielants, H., Sorensen, I. J., Ozgocmen, S., Roussou, E., Valle-Onate, R., Weber, U., Wei, J., & Sieper, J. (2009). The development of Assessment of SpondyloArthritis International Society classification criteria for axial spondyloarthritis (part II): Validation and final selection. Annals of Rheumatic Diseases, 68(6), 777–783.

    Article  CAS  Google Scholar 

  21. National Kidney Foundation.(2002). K/DOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. American Journal of Kidney Diseases, 39(2 Suppl 1), S1–S266.

    Google Scholar 

  22. Yang, F., Wang, V. W., Joshi, V. D., Lau, T. W., & Luo, N. (2013). Validation of the English version of the Kidney Disease Quality of Life questionnaire (KDQOL-36) in haemodialysis patients in Singapore. Patient, 6(2), 135–141.

    Article  PubMed  Google Scholar 

  23. Laucis, N. C., Hays, R. D., & Bhattacharyya, T. (2015). Scoring the SF-36 in orthopaedics: A brief guide. The Journal of Bone and Joint Surgery. American Volume, 97(19), 1628–1634.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Kwan, Y. H., Fong, W., Tan, V. I. C., Lui, N. L., Malhotra, R., Ostbye, T., & Thumboo, J. (2017). A systematic review of quality-of-life domains and items relevant to patients with spondyloarthritis. Seminars in Arthritis and Rheumatism, 47(2), 175–182.

    Article  PubMed  Google Scholar 

  25. Poddubnyy, D. (2013). Axial spondyloarthritis: Is there a treatment of choice? Therapeutic Advances in Musculoskeletal Disease, 5(1), 45–54.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  26. Kilic, G., Kilic, E., & Ozgocmen, S. (2014). Relationship between psychiatric status, self-reported outcome measures, and clinical parameters in axial spondyloarthritis. Medicine (Baltimore), 93(29), e337.

    Article  Google Scholar 

  27. Chan Cynthia, Y. (2018). Depression and anxiety in axial spondyloarthritis. Hong Kong Bulletin on Rheumatic Diseases. https://doi.org/10.2478/hkbrd-2018-0001.

  28. Ehde, D. M., Dillworth, T. M., & Turner, J. A. (2014). Cognitive-behavioral therapy for individuals with chronic pain: Efficacy, innovations, and directions for research. American Psychologist, 69(2), 153–166.

    Article  PubMed  Google Scholar 

  29. Kwok, J. Y., Choi, K. C., & Chan, H. Y. (2016). Effects of mind-body exercises on the physiological and psychosocial well-being of individuals with Parkinson’s disease: A systematic review and meta-analysis. Complementary Therapies in Medicine, 29, 121–131.

    Article  PubMed  Google Scholar 

  30. Walsh, D. (2017). Guidelines and recommendations for managing challenging chronic pain conditionsI83. The National Institute for Health and Care Excellence revised guidelines for the management of non-specific low back pain and sciatica. Rheumatology. https://doi.org/10.1093/rheumatology/kex060.002.

  31. Turan, Y., Duruöz, M. T., & Cerrahoglu, L. (2009). Relationship between enthesitis, clinical parameters and quality of life in spondyloarthritis. Joint Bone Spine, 76(6), 642–647.

    Article  PubMed  Google Scholar 

Download references

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore

    Yu Heng Kwan, Rahul Malhotra, Truls Østbye & Julian Thumboo

  2. Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore

    Warren Fong, Ying Ying Leung, Jie Kie Phang, Nai Lee Lui & Julian Thumboo

  3. Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore

    Priscilla How & Hwee-Lin Wee

  4. Duke-NUS Medical School, Singapore, Singapore

    Warren Fong

  5. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Warren Fong & Julian Thumboo

  6. Division of Nephrology, Department of Medicine, National University Hospital, Singapore, Singapore

    Priscilla How

  7. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

    Hwee-Lin Wee & Chuen Seng Tan

Authors
  1. Yu Heng Kwan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Warren Fong
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Priscilla How
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hwee-Lin Wee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ying Ying Leung
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jie Kie Phang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nai Lee Lui
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Chuen Seng Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Rahul Malhotra
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Truls Østbye
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Julian Thumboo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Julian Thumboo.

Ethics declarations

Disclaimer

None.

Conflict of interest

The authors declare that there is no other conflict of interest to disclose. There is no funding provided for the production of this manuscript.

Ethical approval

The SingHealth Centralised Institutional Review Board and the Domain Specific Review Board of the National University Hospital Singapore approved this research.

Informed consent

All patients provided written informed consent to participate in this research.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 28 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kwan, Y.H., Fong, W., How, P. et al. The impact of axial spondyloarthritis on quality of life (QoL): a comparison with the impact of moderate to end-stage chronic kidney disease on QoL. Qual Life Res 27, 2321–2327 (2018). https://doi.org/10.1007/s11136-018-1900-x

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-018-1900-x

Keywords

Search

Navigation