This study was supported by Grant DTCRD102(2)-I-08 from the Buddhist Dalin Tzu Chi Hospital
Disability -- Acceptance of, Nephrology -- Taiwan, Kidneys -- Diseases -- Mortality
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.
© 2015 Chiang et al.
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Chiang, H.-H., Livneh, H., Guo, H.-R., Yen, M.-L., & Tsai, T.-Y. (2015). Effects of acceptance of disability on death or dialysis in chronic kidney disease patients: a 3-year prospective cohort study. BMC Nephrology, 16(1), 202.