Sleep disorders, depressive symptoms and health-related quality of life--a cross-sectional comparison between kidney transplant recipients and waitlisted patients on maintenance dialysis

Abstract Background The symptoms and complications related to chronic liver disease (CLD) have been shown to affect patient well-being. Currently there is limited research data on how CLD severity may affect both health-related quality of life (HRQOL) and the development of depressive symptoms in CLD patients. Moreover, the ongoing advances in CLD treatment, and its effect on HRQOL, highlight the need for further studies. Therefore, the aim of the present study was to evaluate if the CLD severity may affect the HRQOL and the development of depressive symptoms. Methods A cross-sectional study was conducted. Patients with CLDs were identified at their regular visits to the outpatient clinic of the Sant’Orsola-Malpighi Hospital in Bologna, between September 2016 and July 2017. HRQOL was measured with Short Form 12 (SF-12) and Nottingham Health Profile (NHP) questionnaires; depressive symptoms were measured with Beck Depression Inventory-II (BDI). CLD severity was measured using the MELD score and the sample was stratified into five classes according to it. Group comparisons were conducted using the Kruskal–Wallis test. Results Two hundred and fifty-four patients were included. Mean age was 62.84 years (SD 11.75) and 57.9% were male. Most participants were affected by compensated cirrhosis (140.2%) and chronic hepatitis (40.2%), with a disease duration ≥ 5 years (69.3%). Regarding the MELD score, 67.7% of patients belonged to Class I, 29.9% to Class II, and 2.4% to Class III. There were not patients belonging to the Classes IV and V. No statistically significant differences were found in all SF-12 and NHP domains between the MELD classes, except for CLD impact on sexual life and holidays (p = 0.037 and p = 0.032, respectively). A prevalence rate of 26% of depressive symptoms was reported, no statistically significant differences were found in BDI-II total scores between the three MELD classes. Conclusions All domains of HRQOL and depression were altered in CLDs patients, nevertheless CLD severity was not confirmed as an affecting factor for HRQOL.

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Disparity in health-related quality of life between kidney transplant recipients and hemodialysis patients, and related implications for physical rehabilitation: A cross-sectional study

10.21203/rs.3.rs-142930/v2 ◽

2021 ◽

Author(s):

Adnan L Sarhan ◽

Raya H Jarareh ◽

Mujahed Shraim

Keyword(s):

Physical Functioning ◽

Cross Sectional Study ◽

Health Related Quality ◽

Transplant Recipients ◽

Sectional Study ◽

Kidney Transplant Recipients ◽

Cross Sectional ◽

Related Quality ◽

Health Related

Abstract Background Health related quality of life (HRQOL) is an important indicator of medical treatment and is a strong predictor of disability and mortality. The literature has shown mixed evidence about whether kidney transplantation improves HRQOL compared with other renal replacement modalities. The aim of this study was to compare the HRQOL in kidney transplant recipients (KTRs) and hemodialysis (HD) patients. Methods A cross-sectional study of 100 KTRs and 272 HD patients from two central kidney units in West Bank, Palestine. The HRQOL was assessed using the Short Form-36 Health Survey. Multivariable linear regression was used to estimate differences in mean HRQOL scores between KTRs and HD patients. Results After accounting for sociodemographic variables, KTRs had higher clinically important differences than HD patients in HRQOL mean scores in role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health, physical and mental component summaries ranging from 15.5 points for social functioning (95% CI 10.1, 20.7) to 34.3 points for general health (95% CI 28.7, 39.9). However, unexpectedly, KTRs had significantly lower HRQOL physical functioning than HD patients by 24.5 points (95% CI 18.7, 29.9). Conclusions Kidney transplantation is associated with important improvements in most aspects of HRQOL but also with noticeably poor physical functioning. HRQOL among KTRs should be routinely measured and closely monitored in clinical settings. KTRs should be encouraged to participate in individually tailored physical exercise programs. Identification and elimination of barriers to physical functioning may improve HRQOL and prevent premature mortality among KTRs.

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Airflow Limitation, Fatigue, and Health-Related Quality of Life in Kidney Transplant Recipients

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.06600521 ◽

2021 ◽

Vol 16 (11) ◽

pp. 1686-1694

Author(s):

Tim J. Knobbe ◽

Daan Kremer ◽

Michele F. Eisenga ◽

Marco van Londen ◽

António W. Gomes-Neto ◽

...

Keyword(s):

Quality Of Life ◽

Kidney Transplant ◽

Airflow Limitation ◽

Health Related Quality ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Content Type ◽

Related Quality ◽

Health Related

Background and objectivesMany kidney transplant recipients suffer from fatigue and poor health-related quality of life. Airflow limitation may be an underappreciated comorbidity among kidney transplant recipients, which could contribute to fatigue and lower health-related quality of life in this population. In this study, we compared the prevalence of airflow limitation between kidney transplant recipients and healthy controls and investigated associations of airflow limitation with fatigue and health-related quality of life in kidney transplant recipients.Design, setting, participants, & measurementsData from the ongoing TransplantLines Biobank and Cohort study were used. Airflow limitation was defined as forced exhaled volume in 1 second less than the fifth percentile of the general population. Fatigue and health-related quality of life were assessed using checklist individual strength 20 revised (CIS20-R) and Short Form-36 (SF-36) questionnaires.ResultsA total of 539 kidney transplant recipients (58% men; mean age 56±13 years) and 244 healthy controls (45% men; mean age 57±10 years) were included. Prevalence of airflow limitation was higher in kidney transplant recipients than in healthy controls (133 [25%] versus 25 [10%]). In multinomial regression models, airflow limitation was independently associated with fatigue severity (odds ratio moderate fatigue, 1.68; 95% confidence interval, 0.92 to 3.09 and odds ratio severe fatigue, 2.51; 95% confidence interval, 1.39 to 4.55; P=0.007) and lower physical health-related quality of life (−0.11 SDs; 95% confidence interval, −0.19 to −0.02; P=0.01) in kidney transplant recipients. In exploratory mediation analyses, fatigue accounted for 79% of the association of airflow limitation with physical health-related quality of life.ConclusionsAirflow limitation is common among kidney transplant recipients. Its occurrence is associated with more than two times higher risk of severe fatigue, and it is associated with lower physical health-related quality of life. Mediation analyses suggest that airflow limitation causes fatigue, which in turn, decreases physical health-related quality of life.Clinical Trial registry name and registration number:TransplantLines: The Transplantation Biobank, NCT03272841PodcastThis article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2021_11_08_CJN06600521.mp3

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