Effects of acceptance of disability on death or dialysis in chronic kidney disease patients

A 3-year prospective cohort study

Hsin Hung Chiang, Hanoch Livneh, How-Ran Guo, Mei Ling Yen, Tzung Yi Tsai

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Background: Acceptance of disability (AOD) is a useful construct that assesses the ability of a patient to psychologically cope with chronic diseases, but its effect on long-term outcomes of patients with chronic kidney disease (CKD) remains unclear. This study aimed to evaluate the relation between AOD level and clinical outcomes in a cohort of CKD patients in Taiwan. Methods: 262 CKD patients without dialysis at a hospital in Taiwan were consecutively recruited, from 2010 to 2011, and followed up for 3 years. At enrollment, demographic and clinical data were obtained, including baseline level measurement of AOD, using the Acceptance of Disability Scale-Revised (AODS-R). During follow-up, the authors assessed the effect of AOD on progression to dialysis and all-cause mortality by using Cox proportional hazard regression analysis. Results: Of the patients included in the analyses, 145 (55-3 %) whose total scores of AOD were below the median (86-00) were regarded as having low AOD at enrollment. At the end of 3-year follow-up, 25 have died and 57 initiated dialysis. Participants with low AOD were more likely to have the composite end-point of progression to dialysis or death (adjusted hazard ratios [AHR] = 1-89, 95 % confidence interval [CI]: 1-18-3-20). In addition, CKD stage at IV or above and hemoglobin level were found to be associated with the occurrence of the composite end-point. Conclusion: AOD was associated with an increased risk for poor clinical outcomes, thus suggesting that prompt awareness and management of the psychological reactions may improve clinical outcomes of patients with CKD.

Original languageEnglish
Article number0197-z
JournalBMC Nephrology
Volume16
Issue number1
DOIs
Publication statusPublished - 2015 Dec 5

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Chronic Renal Insufficiency
Dialysis
Cohort Studies
Prospective Studies
Taiwan
Hemoglobins
Chronic Disease
Regression Analysis
Demography
Confidence Intervals
Psychology
Mortality

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

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title = "Effects of acceptance of disability on death or dialysis in chronic kidney disease patients: A 3-year prospective cohort study",
abstract = "Background: Acceptance of disability (AOD) is a useful construct that assesses the ability of a patient to psychologically cope with chronic diseases, but its effect on long-term outcomes of patients with chronic kidney disease (CKD) remains unclear. This study aimed to evaluate the relation between AOD level and clinical outcomes in a cohort of CKD patients in Taiwan. Methods: 262 CKD patients without dialysis at a hospital in Taiwan were consecutively recruited, from 2010 to 2011, and followed up for 3 years. At enrollment, demographic and clinical data were obtained, including baseline level measurement of AOD, using the Acceptance of Disability Scale-Revised (AODS-R). During follow-up, the authors assessed the effect of AOD on progression to dialysis and all-cause mortality by using Cox proportional hazard regression analysis. Results: Of the patients included in the analyses, 145 (55-3 {\%}) whose total scores of AOD were below the median (86-00) were regarded as having low AOD at enrollment. At the end of 3-year follow-up, 25 have died and 57 initiated dialysis. Participants with low AOD were more likely to have the composite end-point of progression to dialysis or death (adjusted hazard ratios [AHR] = 1-89, 95 {\%} confidence interval [CI]: 1-18-3-20). In addition, CKD stage at IV or above and hemoglobin level were found to be associated with the occurrence of the composite end-point. Conclusion: AOD was associated with an increased risk for poor clinical outcomes, thus suggesting that prompt awareness and management of the psychological reactions may improve clinical outcomes of patients with CKD.",
author = "Chiang, {Hsin Hung} and Hanoch Livneh and How-Ran Guo and Yen, {Mei Ling} and Tsai, {Tzung Yi}",
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Effects of acceptance of disability on death or dialysis in chronic kidney disease patients : A 3-year prospective cohort study. / Chiang, Hsin Hung; Livneh, Hanoch; Guo, How-Ran; Yen, Mei Ling; Tsai, Tzung Yi.

In: BMC Nephrology, Vol. 16, No. 1, 0197-z, 05.12.2015.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Effects of acceptance of disability on death or dialysis in chronic kidney disease patients

T2 - A 3-year prospective cohort study

AU - Chiang, Hsin Hung

AU - Livneh, Hanoch

AU - Guo, How-Ran

AU - Yen, Mei Ling

AU - Tsai, Tzung Yi

PY - 2015/12/5

Y1 - 2015/12/5

N2 - Background: Acceptance of disability (AOD) is a useful construct that assesses the ability of a patient to psychologically cope with chronic diseases, but its effect on long-term outcomes of patients with chronic kidney disease (CKD) remains unclear. This study aimed to evaluate the relation between AOD level and clinical outcomes in a cohort of CKD patients in Taiwan. Methods: 262 CKD patients without dialysis at a hospital in Taiwan were consecutively recruited, from 2010 to 2011, and followed up for 3 years. At enrollment, demographic and clinical data were obtained, including baseline level measurement of AOD, using the Acceptance of Disability Scale-Revised (AODS-R). During follow-up, the authors assessed the effect of AOD on progression to dialysis and all-cause mortality by using Cox proportional hazard regression analysis. Results: Of the patients included in the analyses, 145 (55-3 %) whose total scores of AOD were below the median (86-00) were regarded as having low AOD at enrollment. At the end of 3-year follow-up, 25 have died and 57 initiated dialysis. Participants with low AOD were more likely to have the composite end-point of progression to dialysis or death (adjusted hazard ratios [AHR] = 1-89, 95 % confidence interval [CI]: 1-18-3-20). In addition, CKD stage at IV or above and hemoglobin level were found to be associated with the occurrence of the composite end-point. Conclusion: AOD was associated with an increased risk for poor clinical outcomes, thus suggesting that prompt awareness and management of the psychological reactions may improve clinical outcomes of patients with CKD.

AB - Background: Acceptance of disability (AOD) is a useful construct that assesses the ability of a patient to psychologically cope with chronic diseases, but its effect on long-term outcomes of patients with chronic kidney disease (CKD) remains unclear. This study aimed to evaluate the relation between AOD level and clinical outcomes in a cohort of CKD patients in Taiwan. Methods: 262 CKD patients without dialysis at a hospital in Taiwan were consecutively recruited, from 2010 to 2011, and followed up for 3 years. At enrollment, demographic and clinical data were obtained, including baseline level measurement of AOD, using the Acceptance of Disability Scale-Revised (AODS-R). During follow-up, the authors assessed the effect of AOD on progression to dialysis and all-cause mortality by using Cox proportional hazard regression analysis. Results: Of the patients included in the analyses, 145 (55-3 %) whose total scores of AOD were below the median (86-00) were regarded as having low AOD at enrollment. At the end of 3-year follow-up, 25 have died and 57 initiated dialysis. Participants with low AOD were more likely to have the composite end-point of progression to dialysis or death (adjusted hazard ratios [AHR] = 1-89, 95 % confidence interval [CI]: 1-18-3-20). In addition, CKD stage at IV or above and hemoglobin level were found to be associated with the occurrence of the composite end-point. Conclusion: AOD was associated with an increased risk for poor clinical outcomes, thus suggesting that prompt awareness and management of the psychological reactions may improve clinical outcomes of patients with CKD.

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U2 - 10.1186/s12882-015-0197-z

DO - 10.1186/s12882-015-0197-z

M3 - Review article

VL - 16

JO - BMC Nephrology

JF - BMC Nephrology

SN - 1471-2369

IS - 1

M1 - 0197-z

ER -