MO190: Experiences of Being a Living Kidney-Donor-Perceived and Measured Stress Levels before and after Kidney Donation

Abstract

Abstract BACKGROUND AND AIMS Living kidney donation is the preferred kidney replacement therapy considering graft function and survival rates. To donate a kidney is a life-changing experience, and there is a diverse spectrum of emotions connected to this process. The aim of this study was to investigate kidney donors' perceived and measured stress levels before and after donation. Furthermore, to investigate if the level of perceived stress could be linked to the degree of metabolic stress measured using saliva cortisol, serum glucose and insulin levels. METHOD A prospective observational study including 83 patients (46 ± 10.9 years, 63% women), who donated a kidney at Sahlgrenska University Hospital, Gothenburg, during 2009–2010. Three self-rating surveys concerning stress (Everyday Life Stress Scale), vital exhaustion (Maastricht Questionnaire of vital exhaustion) and depressive symptoms (Depressive Mood Scale) were answered on the day before surgery, and then 2 and 6 months after kidney donation (see score details, Table 1). Blood samples of insulin, glucose and saliva cortisol were collected at the same time points. Statistical analyses were carried out to investigate changes over time, potential gender differences, and correlations between laboratory data and survey results. RESULTS Kidney donors generally scored low in self-rating stress mean 15.5 and depression symptom scales mean 10.8 pre-donation. The Maastricht's questionnaire showed a trend toward significant gender difference at 2 months; women mean score was 32.1 ± 9.3 and men 35.8 ± 6.9,  P = .092. At 6 months, there was a significant gender difference in self-reported vital exhaustion, where women scored higher 36.9 ± 7.1 than men 30.7 ± 11.6;  P = .037 and a near significant difference on the Depressive Mood Scale, 12.2 ± 12.5 versus 6.4 ± 8.2 at 6 months; P = .058. No significant difference over time in experienced well-being (Everyday Life Stress Scale) was found, 15.6 ± 8.2 vs 14.3 ± 7.6,  P = .554. Data are displayed in detail in Table 1 and Figure 1. No correlations between metabolic stress measured as salivary cortisol (morning, noon and evening) and HOMA-IR, and perceived stress were found. CONCLUSION Kidney donors self-reported stress level and depressive symptoms did not change pre-donation to 6 months after donation. However, women reported more feelings of exhaustion and stress than men did at 6 months post-donation. In the future, a more structured psychosocial follow-up of kidney donors after at least 6 months is suggested.