From dialysis to transplantation: a 5-year longitudinal study on self-reported quality of life

BMC Nephrology

Ingrid Os²  Anna Varberg Reisæter¹  Amin AG Amro²  Fredrik B Brekke³  Bård Waldum²  Nanna von der Lippe³ 

[1]Department of Transplantation Medicine Rikshospitalet, Oslo University Hospital, Oslo, Norway

[2]Department of Nephrology Ullevål, Oslo University Hospital, Oslo, Norway

[3]Institute of Clinical Medicine, University of Oslo, Oslo, Norway

关键词: Clinical relevant change;    Longitudinal;    KDQOL-SF;    HRQOL;    Kidney transplantation;    Dialysis;   

Others  :  1082544
DOI  :  10.1186/1471-2369-15-191

 received in 2014-09-10, accepted in 2014-11-21,  发布年份 2014

【 摘 要 】

Background

Little is known how health related quality of life (HRQOL) change in the transition from dialysis to renal transplantation (RTX). Longitudinal data addressing the patient-related outcomes are scarce, and particularly data regarding kidney-specific HRQOL are lacking. Thus, the aim of the current study was to assess HRQOL in patients followed from dialysis to RTX. Furthermore, to compare HRQOL in RTX patients and the general population.

Methods

In a prospective study, HRQOL was measured in a cohort of 110 patients (median age 53.5 (IQR 39–62) years, GFR 54 (45–72) ml/min/1.73 m²) in dialysis and after RTX using the self-administered Kidney Disease and Quality of Life Short Form version 1.3 (KDQOL-SF). Generic HRQOL in the RTX patients was compared to that of the general population (n = 5903) using the SF-36. Clinical important change after RTX was defined as difference in HRQOL of SD/2.

Results

Follow-up time was 55 (IQR 50–59) months, and time after RTX was 41 (34–51) months. Four of nine domains in kidney-specific HRQOL improved after RTX, i.e. burden of kidney disease, effect of kidney disease, symptoms and work status. In SF-36, general health, vitality, social function and role physical improved after RTX, but none of the domains improved sufficiently to be regarded as clinically relevant change. There were highly significant differences in HRQOL between RTX patients and the general population after adjustment for age and gender for all items of SF-36 except for bodily pain and mental health.

Conclusions

HRQOL improved in the transition from dialysis to transplantation, but clinical relevant change was only obtained in the kidney specific domains. HRQOL was perceived considerably poorer in RTX patients than in the general population. Our observations point to the need of improving HRQOL even after RTX, and should encourage further longitudinal research and clinical attention during treatment shift.

【 授权许可】

   
2014 von der Lippe et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Unruh ML, Weisbord SD, Kimmel PL: Health-related quality of life in nephrology research and clinical practice. Semin Dial 2005, 18(2):82-90.
• [2]Osthus TB, Dammen T, Sandvik L, Bruun CM, Nordhus IH, Os I: Health-related quality of life and depression in dialysis patients: associations with current smoking. Scand J Urol Nephrol 2010, 44(1):46-55.
• [3]Mazairac AH, de Wit GA, Penne EL, van der Weerd NC, de Jong B, Grooteman MP, van den Dorpel MA, Buskens E, Dekker FW, Nube MJ, ter Wee PM, Boeschoten EW, Bots ML, Blankestijn PJ: Changes in quality of life over time–Dutch haemodialysis patients and general population compared. Nephrol Dial Transplant 2011, 26(6):1984-1989.
• [4]Laupacis A, Keown P, Pus N, Krueger H, Ferguson B, Wong C, Muirhead N: A study of the quality of life and cost-utility of renal transplantation. Kidney Int 1996, 50(1):235-242.
• [5]Mittal SK, Ahern L, Flaster E, Maesaka JK, Fishbane S: Self-assessed physical and mental function of haemodialysis patients. Nephrol Dial Transplant 2001, 16(7):1387-1394.
• [6]Osthus TB, von der Lippe N, Ribu L, Rustoen T, Leivestad T, Dammen T, Os I: Health-related quality of life and all-cause mortality in patients with diabetes on dialysis. BMC Nephrol 2012, 13:78.
• [7]Wolfe RA, Ashby VB, Milford EL, Ojo AO, Ettenger RE, Agodoa LY, Held PJ, Port FK: Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med 1999, 341(23):1725-1730.
• [8]Neovius M, Jacobson SH, Eriksson JK, Elinder CG, Hylander B: Mortality in chronic kidney disease and renal replacement therapy: a population-based cohort study. BMJ Open 2014, 4(2):e004251.
• [9]Fujisawa M, Ichikawa Y, Yoshiya K, Isotani S, Higuchi A, Nagano S, Arakawa S, Hamami G, Matsumoto O, Kamidono S: Assessment of health-related quality of life in renal transplant and hemodialysis patients using the SF-36 health survey. Urology 2000, 56(2):201-206.
• [10]Kovacs AZ, Molnar MZ, Szeifert L, Ambrus C, Molnar-Varga M, Szentkiralyi A, Mucsi I, Novak M: Sleep disorders, depressive symptoms and health-related quality of life–a cross-sectional comparison between kidney transplant recipients and waitlisted patients on maintenance dialysis. Nephrol Dial Transplant 2011, 26(3):1058-1065.
• [11]Griva K, Davenport A, Harrison M, Newman SP: The impact of treatment transitions between dialysis and transplantation on illness cognitions and quality of life - a prospective study. Br J Health Psychol 2012, 17(4):812-827.
• [12]Ortega T, Deulofeu R, Salamero P, Roman A, Masnou N, Rubio S, Garcia O, Casanovas T, Cofan F, Twose J, Ortega F: Health-related quality of life before and after a solid organ transplantation (kidney, liver, and lung) of four Catalonia hospitals. Transplant Proc 2009, 41(6):2265-2267.
• [13]Jofre R, Lopez-Gomez JM, Moreno F, Sanz-Guajardo D, Valderrabano F: Changes in quality of life after renal transplantation. Am J Kidney Dis 1998, 32(1):93-100.
• [14]Painter P, Krasnoff JB, Kuskowski M, Frassetto L, Johansen K: Effects of modality change on health-related quality of life. Hemodial Int 2012, 16(3):377-386.
• [15]Joshi SA, Almeida N, Almeida A: Assessment of the perceived quality of life of successful kidney transplant recipients and their donors pre- and post-transplantation. Transplant Proc 2013, 45(4):1435-1437.
• [16]Pinson CW, Feurer ID, Payne JL, Wise PE, Shockley S, Speroff T: Health-related quality of life after different types of solid organ transplantation. Ann Surg 2000, 232(4):597-607.
• [17]Kugler C, Gottlieb J, Warnecke G, Schwarz A, Weissenborn K, Barg-Hock H, Bara C, Einhorn I, Haverich A, Haller H: Health-related quality of life after solid organ transplantation: a prospective, multiorgan cohort study. Transplantation 2013, 96(3):316-323.
• [18]Griva K, Stygall J, Ng JH, Davenport A, Harrison MJ, Newman S: Prospective changes in health-related quality of life and emotional outcomes in kidney transplantation over 6 years. J Transplant 2011, 2011:671571.
• [19]Aasebo W, Homb-Vesteraas NA, Hartmann A, Stavem K: Life situation and quality of life in young adult kidney transplant recipients. Nephrol Dial Transplant 2009, 24(1):304-308.
• [20]Overbeck I, Bartels M, Decker O, Harms J, Hauss J, Fangmann J: Changes in quality of life after renal transplantation. Transplant Proc 2005, 37(3):1618-1621.
• [21]Matas AJ, McHugh L, Payne WD, Wrenshall LE, Dunn DL, Gruessner RW, Sutherland DE, Najarian JS: Long-term quality of life after kidney and simultaneous pancreas-kidney transplantation. Clin Transplant 1998, 12(3):233-242.
• [22]Maglakelidze N, Pantsulaia T, Tchokhonelidze I, Managadze L, Chkhotua A: Assessment of health-related quality of life in renal transplant recipients and dialysis patients. Transplant Proc 2011, 43(1):376-379.
• [23]Ortega F, Valdés C, Ortega T: Quality of life after solid organ transplantation. Transplant Rev 2007, 21(3):155-170.
• [24]Annual Report 2010 from the Norwegian Renal Registry http://www.nephro.no/nnr/AARSMEL2010.pdf webcite
• [25]Beddhu S, Bruns FJ, Saul M, Seddon P, Zeidel ML: A simple comorbidity scale predicts clinical outcomes and costs in dialysis patients. Am J Med 2000, 108(8):609-613.
• [26]Jassal SV, Schaubel DE, Fenton SS: Baseline comorbidity in kidney transplant recipients: a comparison of comorbidity indices. Am J Kidney Dis 2005, 46(1):136-142.
• [27]Samordnet levekårsundersøkelse 2002-tverrsnittsundersøkelsen http://www.ssb.no/a/publikasjoner/pdf/notat_200422/notat_200422.pdf webcite
• [28]World Medical Association Declaration of Helsinki http://www.wma.net/en/30publications/10policies/b3/17c.pdf webcite
• [29]Hays RD, Kallich JD, Mapes DL, Coons SJ, Carter WB: Development of the kidney disease quality of life (KDQOL) instrument. Qual Life Res 1994, 3(5):329-338.
• [30]Ware JE Jr, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992, 30(6):473-483.
• [31]Korevaar JC, Merkus MP, Jansen MA, Dekker FW, Boeschoten EW, Krediet RT: Validation of the KDQOL-SF: a dialysis-targeted health measure. Qual Life Res 2002, 11(5):437-447.
• [32]Barotfi S, Molnar MZ, Almasi C, Kovacs AZ, Remport A, Szeifert L, Szentkiralyi A, Vamos E, Zoller R, Eremenco S, Novak M, Mucsi I: Validation of the kidney disease quality of life-short form questionnaire in kidney transplant patients. J Psychosom Res 2006, 60(5):495-504.
• [33]Norman GR, Sloan JA, Wyrwich KW: Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care 2003, 41(5):582-592.
• [34]J C: Statistical Power Analysis for the Behavioral Sciences. 2nd edition. NJ, USA: Lawrence Erlbaum Assoc; 1988.
• [35]Hjermstad MJ, Fayers PM, Bjordal K, Kaasa S: Using reference data on quality of life–the importance of adjusting for age and gender, exemplified by the EORTC QLQ-C30 (+3). Eur J Cancer 1998, 34(9):1381-1389.
• [36]Kidney disease quality of life short form, version 1.3: a manual for use and scoring http://www.rand.org/content/dam/rand/pubs/papers/2006/P7994.pdf webcite
• [37]Gorodetskaya I, Zenios S, McCulloch CE, Bostrom A, Hsu CY, Bindman AB, Go AS, Chertow GM: Health-related quality of life and estimates of utility in chronic kidney disease. Kidney Int 2005, 68(6):2801-2808.
• [38]Neri L, Dukes J, Brennan DC, Salvalaggio PR, Seelam S, Desiraju S, Schnitzler M: Impaired renal function is associated with worse self-reported outcomes after kidney transplantation. Qual Life Res 2011, 20(10):1689-1698.
• [39]Lee AJ, Morgan CL, Conway P, Currie CJ: Characterisation and comparison of health-related quality of life for patients with renal failure. Curr Med Res Opin 2005, 21(11):1777-1783.
• [40]Bakewell AB, Higgins RM, Edmunds ME: Does ethnicity influence perceived quality of life of patients on dialysis and following renal transplant? Nephrol Dial Transplant 2001, 16(7):1395-1401.
• [41]Skingley A: Older people, isolation and loneliness: implications for community nursing. Br J Community Nurs 2013, 18(2):84-90.
• [42]Akin S, Mendi B, Ozturk B, Cinper C, Durna Z: Assessment of relationship between self-care and fatigue and loneliness in haemodialysis patients. J Clin Nurs 2014, 23(5–6):856-864.
• [43]Griva K, Ziegelmann JP, Thompson D, Jayasena D, Davenport A, Harrison M, Newman SP: Quality of life and emotional responses in cadaver and living related renal transplant recipients. Nephrol Dial Transplant 2002, 17(12):2204-2211.
• [44]Rebollo P, Ortega F, Baltar JM, Badia X, Alvarez-Ude F, Diaz-Corte C, Naves M, Navascues RA, Urena A, Alvarez-Grande J: Health related quality of life (HRQOL) of kidney transplanted patients: variables that influence it. Clin Transplant 2000, 14(3):199-207.
• [45]Wight JP, Edwards L, Brazier J, Walters S, Payne JN, Brown CB: The SF36 as an outcome measure of services for end stage renal failure. Qual Health Care 1998, 7(4):209-221.
• [46]Fallon M, Gould D, Wainwright SP: Stress and quality of life in the renal transplant patient: a preliminary investigation. J Adv Nurs 1997, 25(3):562-570.
• [47]Crosby RD, Kolotkin RL, Williams GR: Defining clinically meaningful change in health-related quality of life. J Clin Epidemiol 2003, 56(5):395-407.
• [48]Smith D, Loewenstein G, Jepson C, Jankovich A, Feldman H, Ubel P: Mispredicting and misremembering: patients with renal failure overestimate improvements in quality of life after a kidney transplant. Health Psychol 2008, 27(5):653-658.
• [49]Amro A, Waldum B, Dammen T, Miaskowski C, Os I: Symptom clusters in patients on dialysis and their association with quality-of-life outcomes. J Ren Care 2014, 40(1):23-33.
• [50]Bentsen SB, Rokne B, Wahl AK: Comparison of health-related quality of life between patients with chronic obstructive pulmonary disease and the general population. Scand J Caring Sci 2013, 27(4):905-912.
• [51]Ribu L, Hanestad BR, Moum T, Birkeland K, Rustoen T: A comparison of the health-related quality of life in patients with diabetic foot ulcers, with a diabetes group and a nondiabetes group from the general population. Qual Life Res 2007, 16(2):179-189.
• [52]Sprangers MAG, Schwartz CE: Integrating response shift into health-related quality of life research: a theoretical model. Soc Sci Med A 1999, 48(11):1515.