OBJECTIVES: Chronic kidney disease (CKD) affects 10% of people globally. Significant reductions in quality of life (QoL) are well documented in late-stage CKD (CKD4/5), but there is uncertainty about how QoL is affected in early stages (CKD1/2). We sought to synthesize current evidence to better understand QoL impacts in early-stage CKD.

METHODS: A targeted literature review (TLR) of studies measuring QoL in CKD was undertaken. Medline and Embase were searched from 2013 to 2023. Studies were selected according to pre-defined criteria. Studies using the EQ-5D, SF-36 or KDQOL and reporting CKD1/2 evidence separately from other CKD stages were included.

RESULTS: Of the 3052 papers identified, 111 studies used the selected QoL instruments. Only eight studies reported evidence separately for QoL in CKD1/2, of which one study reported using the KDQOL, three the EQ-5D and four the SF-36. Three studies identified significantly lower QoL overall in CKD2 compared to the general population or patients without CKD. The difference in QoL decrements between the general population and CKD2 compared with those between CKD2-5 was clinically meaningfully different in four domains in the KDQOL study. In two studies, QoL in CKD1 or 2 was lower or similar to that in CKD4 or 5 in multiple SF-36 and KDQOL-SF domains. When assessed using the KDQOL there was no statistical difference in QoL across CKD stages in 6 out of 11 kidney disease-targeted domains. Stage 2 QoL was worse than or similar to CKD3-4 in the effects and burden of kidney disease domains.

CONCLUSIONS: Quality of life is negatively impacted by early-stage CKD but evidence is limited. A better understanding of the validity of QoL instruments in early-stage CKD and the measurement of QoL in trials, is required for reimbursement decision-making, in order that patients are better supported across all CKD stages.