Health Related Quality of Life in Post Renal Transplant Patients

Abstract

Background To study association of health related quality of life (HRQoL) with renal function in renal transplant recipients and to examine which clinical measures after renal transplantation are connected to aspects of their HRQOL. Materials & Methods The study was carried out at IKDRC/ITS, Ahmedabad between 2013 to 2016. Minimum 3 months post transplant was the inclusion criteria for the study. 54 renal transplant patients gave their consent to participate in the study. The responses were summarized and transformed to give eight summary scales which were grouped as physical component summary (PCS) and mental component summary (MCS) to give total HRQoL. Results Out of 54 patients, 74% were male and 26% patients were female. Age distribution was between 18 to 62 years. Most common cause of end stage renal disease was chronic glomerulonephritis (42.6%). 47 patients underwent live related kidney transplant while 7 received kidneys from cadaver. 8 patients out of 54 (14.8%) were well nourished, 45 patients (83.3%) had mild malnutrition and 1 patient (1.85%) had moderate malnutrition. Mental health(MH) and MCS score in males was significantly higher (<0.05) than females. With respect to age, the transplant patients were divided into four groups: younger than 30 years, 30 to 39 years, 40 to 49 years, and 50 years old or older. No differences were found in any scale score between the age groups. The scale scores of PCS in the patients with a creatinine level >2 mg/dL were significantly lower (<0.05) than those of the patients with less than 2mg/dl. Approx. 33.3% patients had an occurrence of clinically defined acute rejection after transplantation. When compared in between patients who had rejection to those who did not, there was no significant difference in MCS and PCS. The scores of the patients with cadaveric transplantation were similar to those who received a living-related transplantation. Longer time since the transplantation operation were associated with lower scores of the Vitality scale (P<0.01). Conclusion In our study, we found that patients with a relatively high serum creatinine level reported more problems with PCS (Physical component score). Mental components were significantly better in males as compare to females. Episodes of hospitalization and rejection episodes did not affect the present HRQoL. Rejection episodes did not affect present HRQoL. Thus we observed that SF-36 V2 (Short form 36 version 2 ) is a good tool to monitor HRQoL of renal transplant recipients.