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13-04-2020 | Uitgave 9/2020

Quality of Life Research 9/2020

Trends and predictors of multidimensional health-related quality of life after living donor kidney transplantation

Quality of Life Research > Uitgave 9/2020
John D. Peipert, Juan Carlos Caicedo, John J. Friedewald, Michael M. I. Abecassis, David Cella, Daniela P. Ladner, Zeeshan Butt
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The online version of this article (https://​doi.​org/​10.​1007/​s11136-020-02498-2) contains supplementary material, which is available to authorized users.
A correction to this article is available online at https://​doi.​org/​10.​1007/​s11136-020-02574-7.

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Living donor kidney transplant (LDKT) imparts the best graft and patient survival for most end-stage kidney disease (ESKD) patients. Yet, there remains variation in post-LDKT health-related quality of life (HRQOL). Improved understanding of post-LDKT HRQOL can help identify patients for interventions to maximize the benefit of LDKT.


For 477 LDKT recipients transplanted between 11/2007 and 08/2016, we assessed physical, mental, social, and kidney-targeted HRQOL pre-LDKT, as well as 3 and 12 months post-operatively using the SF-36, Kidney Disease Quality of Life—Short Form (KDQOL-SF), and the Functional Assessment of Cancer Therapy—Kidney Symptom Index 19 item version (FKSI-19). We then examined trajectories of each HRQOL domain using latent growth curve models (LGCMs). We also examined associations between decline in HRQOL from 3 months to 12 months post-LDKT and death censored graft failure (DCGF) using Cox regression.


Large magnitude effects (d > 0.80) were observed from pre- to post-LDKT change on the SF-36 Vitality scale (d = 0.81) and the KDQOL-SF Burden of Kidney Disease (d = 1.05). Older age and smaller pre- to post-LDKT decreases in serum creatinine were associated with smaller improvements on many HRQOL scales across all domains in LGCMs. Higher DCGF rates were associated with worse physical [e.g., SF-36 PCSoblique hazard ratio (HR) 1.18; 95% CI 1.01–1.38], mental (KDQOL-SF Cognitive Function HR 1.27; 95% CI 1.00–1.62), and kidney-targeted (FKSI-19 HR: 1.18; 95% CI 1.00–1.38) HRQOL domains.


Clinical HRQOL monitoring may help identify patients who are most likely to have failing grafts and who would benefit from post-LDKT intervention.

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