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Article
Effects of Acceptance of Disability on Death or Dialysis in Chronic Kidney Disease Patients: a 3-Year Prospective Cohort Study
BMC Nephrology
  • Hsin-Hung Chiang, The Buddhist Tzuchi Medical Foundation
  • Hanoch Livneh, Portland State University
  • How-Ran Guo, National Cheng Kung University
  • Mei-Ling Yen, The Buddhist Tzuchi Medical Foundation
  • Tzung-Yi Tsai, National Cheng Kung University
Document Type
Article
Publication Date
12-5-2015
Subjects
  • Disability -- Acceptance of,
  • Nephrology -- Taiwan,
  • Kidneys -- Diseases -- Mortality
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.
Description

Open Access

© 2015 Chiang et al.

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

DOI
10.1186/s12882-015-0197-z
Persistent Identifier
http://archives.pdx.edu/ds/psu/16429
Citation Information
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.