Kidney failure is associated with lower quality of life in young people and limited employment, independence, and relationships compared with healthy peers, according to an analysis led by the University of Bristol and published in the Clinical Journal of the American Society of Nephrology (CJASN).

The University of Bristol reports that, compared with healthy peers, young adults with kidney failure needing renal replacement therapy had lower quality of life. Young adults who need dialysis or a kidney transplant face certain psychosocial challenges not experienced by older people, and the extent to which kidney failure has affected their social status, mental health, and lifestyle remains unclear. To investigate, Dr Alexander Hamilton at the University of Bristol, and his colleagues reviewed all published studies reporting sociodemographic, psychological health, and lifestyle outcomes in people aged between sixteen and thirty with kidney failure on renal replacement therapy (RRT). The participants were either on dialysis or had received a kidney transplant.

The team’s analysis included sixty studies of fifteen thousand five hundred and seventy five participants. Studies were largely single centre cross sectional studies of those transplanted in childhood. Compared with healthy peers, young adults on RRT had lower quality of life, which was for people on dialysis than people who received kidney transplants. They were more likely to be unemployed and to live in the family home, and they were less likely to be married or have a partner. Higher education, alcohol abstinence, and smoking status did not differ.

Dr Alexander Hamilton, Tony Wing Clinical Research Fellow in the Bristol Medical School – Population Health Science, said “We know that most young people with end-stage kidney disease have a kidney transplant, but they are high-risk for the transplanted kidney to fail. There has been much focus both on programs to improve the transition between paediatric and adult care for kidney patients, and clinical end-points. It is vital to understand how kidney failure affects social goals, because by defining these we can seek interventions to improve areas of deficit. These areas really matter to patients.”

Study co-authors include Dr Rhian Clissold, Dr Carol Inward, Dr Fergus Caskey and Professor Yoav Ben-Shlomo.