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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

Tijdschrift:
Quality of Life Research > Uitgave 9/2020
Auteurs:
John D. Peipert, Juan Carlos Caicedo, John J. Friedewald, Michael M. I. Abecassis, David Cella, Daniela P. Ladner, Zeeshan Butt
Belangrijke opmerkingen

Electronic supplementary material

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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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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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