Cross cultural adaptation and validation of the Malay Kidney Disease Quality of Life (KDQOL-36)

BackgroundIn Malaysia, the prevalence of chronic kidney disease is high (9.1%). To date, no questionnaire that specifically assesses the health-related quality of life of patients with chronic kidney disease has been validated in Malaysia. Malay is the national language of Malaysia and spoken by the majority of its citizens. Therefore, the aim of our study was to cross-culturally adapt and validate the Malay Kidney Disease Quality of Life-36 (KDQOL-36) among patients with chronic kidney disease.MethodsThe English version of the KDQOL-36 was translated according to international guidelines to Malay. Content validity was verified by an expert panel and piloted in five patients. Our instrument was then administered to patients with chronic kidney disease stage 1-3A and patients on hemodialysis at baseline and 4weeks later.ResultsA total of 181/232 patients agreed to participate (response rate=78.0%). The majority were male (69.6%) with a median age of 51.0years. Exploratory factor analysis found that the KDQOL-36 had three domains. All three domains showed low to moderate correlation (Spearman's Rho=0.297-0.610) with the Europe Quality of Life Five Dimension questionnaire. Patients on hemodialysis (physical component summary=39.8; mental component summary=53.1;burden of disease=37.5; symptoms/burden list=75.0; effects of kidney disease on daily life=68.8) had significantly worse quality of life than patients with chronic kidney disease stage 1-3A (physical component summary=49.9; mental component summary=52.9; burden of disease=75.0; symptoms/burden list=85.4; effects of kidney disease on daily life=93.8, p<0.001) except for the mental component summary. This indicates that the Malay KDQOL-36 has achieved adequate known-groups validity. Cronbach alpha ranged from 0.872-0.901, indicating adequate internal consistency. At retest, intraclass correlation coefficient ranged from 0.584-0.902, indicating moderate to good correlation.ConclusionThe Malay Kidney Disease Quality of Life-36 was found to be a valid and reliable tool to assess the quality of life in patients with chronic kidney disease. This tool can now be used to assess the health-related quality of life (HRQOL) in patients with chronic kidney disease, as HRQOL is an important independent predictor of patient outcome.