Patient-reported outcomes in chronic kidney disease
The review provides a definition of the concept of «patient-reported outcomes (PRO)». The main components of PRO include health-related quality of life (QoL), symptoms assessed by the patient, functional status, satisfaction with treatment. The review presents a description of the most frequently used questionnaires for assessing QoL in patients with chronic kidney disease (CKD). It has been shown that the physical component of QoL decreases in predialysis stages of CKD. As CKD progresses, the Physical Component Summary (PCS) of the SF-36 questionnaire deteriorates, as well as the scale scores of Physical functioning, Pain, General health, and Role limitations caused by Physical problems (RP). Among the CKD-specific QoL scales, a deterioration in the scores of Symptoms/Problems, Burden of Kidney Disease, Effects of kidney disease on daily life is observed. There are no convincing data in the literature in favor of a decrease in psychosocial aspects of QoL in patients with CKD. The review presents the definition of «comprehensive conservative care» proposed by the experts convened at the 2013 KDIGO Controversies Conference on Supportive Care. It has been shown that comprehensive conservative care can be a fairly effective method of choice for elderly patients with Stage 5 CKD. It has been demonstrated that a decrease in PCS is independently associated with CKD progression and an increased risk of death. However, the information on QoL in predialysis CKD is insufficient. The use of different questionnaires for QoL assessment complicates data comparison. Randomized clinical trials are practically absent, which reduces the value of the results obtained.