HRQoL After Kidney Transplantation: Who Benefits the Most?

Abstract

Aims. Health-Related Quality of Life (HRQoL) in chronic kidney patients is related to treatment modality, being better after kidney transplantation (KT) than during dialysis. We investigated the influence of dialysis modality on HRQoL before and after KT and the role of adherence on HRQoL. Material and methods. 64 dialysis patients who answered the 15D HRQoL survey during dialysis were surveyed again after KT and compared with the general population (GP). Adherence and employment were investigated. Results. The mean 15D score was highest among homehemodialysis patients (HHD) and lowest among in-centre hemodialysis patients (icHD) compared with the GP (P<0.001).Figure: No Caption available.Mean 15D improved in all groups after KT. 78.6% of peritoneal dialysis patients (PD) had a clinically significantly improved 15D score whereas only 47.6% of HHD improved their 15D score and 28.6% remained unchanged. For icHD 53.8% improved their 15D score and 23.1% remained unchanged. A deterioration in the 15D score occurred in 14.3% of PD, 23.1% of icHD and 23.8% of HHD patients and this was related to the number of pills (P=0.04).Figure: No Caption available.Adherence to medication was the lowest in PD. Timing was the most challenging task (not taking on time 25% HHD vs 62% PD patients P=0.03). Timing was related to a higher creatinine concentration (never forgot 125 μmol/L vs forgot 184 μmol/L P=0.05). Employed patients had a higher mean 15D score. Conclusions. HRQoL improved after KT but remained lower than the HRQoL of GP. icHD and PD patients benefited the most, whereas HHD patients had the best HRQoL during dialysis and only 47% experienced a clinically significant improvement after KT. Low pill burden and employment were associated with better HRQoL.