Lifestyle Changes Difficult But Beneficial for Patients with CKD, Study Finds

James Jackson

Credit: LinkedIn

Findings from a recent study are providing clinicians with an overview of the impact of implementing physician-recommended lifestyle changes for individuals with chronic kidney disease (CKD).

Data presented at the American Society of Nephrology Kidney Week 2023 showed nearly all patients in the study reported difficulty implementing lifestyle changes recommended by their physician, but successful implementation led to improvements across several dimensions of physical health, mental health, and overall quality of life.¹

“On top of prescribed therapy, physicians should always try to recommend lifestyle changes for their patients. But we were interested in looking at the consequences of if patients don’t succeed at making those changes,” said James Jackson, director of Adelphi Real World, in an interview with HCPLive Nephrology.

The US Centers for Disease Control and Prevention estimates 15% of US adults have CKD, many of whom suffer from other health problems as a result of their condition. Lifestyle changes have been shown to affect clinical outcomes in patients with CKD and help affected individuals manage their disease, although less is known about the patient-reported impact of successfully implementing these changes.²

To assess the impact of lifestyle changes on quality of life in patients with CKD, Jackson and colleagues used data from the Adelphi CKD Disease Specific Programme, a cross-sectional survey of physicians and patients conducted in the United States from January-June 2022, and compared successes in implementing recommended lifestyle changes. Investigators formed 2 groups based on responses to the SF-12 and self-reports on successes in implementing recommended lifestyle changes, comparing results using T-tests.¹

Among the 221 patients who provided data for the study, the mean age was 63.2 (Standard deviation [SD], 12.58) years, 55% were male, and 66% were white. Lifestyle changes were recommended to 74% of participants, and 95% of these patients reported difficulty implementing the change. Of this group, 20% reported extreme difficulty. The most frequently recommended lifestyle changes were reducing dietary sodium intake (76%), reducing intake of foods high in sugar (71%), and starting/increasing exercise (61%).¹

In the SF-12 physical health domain, the following lifestyle changes had the largest difference in composite scores between the successful and unsuccessful groups:

• Stopping/reducing alcohol consumption (14.1; P < .001)
• Improving sleep pattern (11.9; P < .001)
• Starting/increasing exercise (10.9; P < .001)
• Reaching/maintaining a healthy weight (10.3; P < .001).

In the SF-12 mental health domain, the following lifestyle changes had the largest difference in composite scores between the successful and unsuccessful groups:

• Stopping/reducing alcohol consumption (15.2; P < .001)
• Stopping/reducing smoking (13.6; P = .012)
• Reaching/maintaining a healthy weight (8.4; P = .002
• Reducing potassium intake (7.8; P < .001)
• Consulting a nutritionist (7.3; P = .017)

In total, 84% of patients reported experiencing benefits from their lifestyle changes, the most common being improved quality of life (43%). Of note, CKD-specific benefits were reported less frequently (23%).¹

“With our data, there’s a significant impact on quality of life for those who do and don’t implement the changes. Are patients the problem, or is it that physicians aren’t taking the time to explain the consequences to patients if they don’t implement those changes? If the patients are finding it difficult, is there anything more physicians should be doing to help them? Patients need to make lifestyle changes, but sometimes it can be difficult and have a big impact on their overall quality of life,” Jackson concluded.

References:

1. Jackson J, Taylor DA, Jamee M, et al. Impact of Lifestyle Changes on Quality of Life in Patients with CKD: Results from a Real-World Study. Paper Presented at: American Society of Nephrology Kidney Week 2023. November 1-5, 2023.
2. Centers for Disease Control and Prevention. Chronic Kidney Disease Basics. Chronic Kidney Disease Initiative. February 28, 2022. Accessed November 6, 2023. https://www.cdc.gov/kidneydisease/basics.html