Which Factors Influence Quality of Life of Type 1 Diabetic Patients with End-Stage Renal Disease Subjected to Kidney or Simultaneous Pancreas-Kidney Transplantation?

Abstract

Introduction: The aim of kidney transplantation (KTx) or simultaneous pancreas-kidney transplantation (SPK) in type 1 diabetic patients with end stage renal disease (ESRD) is not only to improve general state of health and prolong long term survival of the recipient but also improve his quality of life (QOL). The aim of the study was to analyse factors that influence QOL of type 1 diabetic patients with ESDR subjected to KTx or SPK in long term follow up after transplantation. Methods: 49 recipients were involved into the analysis. 27 patients were subjected to KTx and 22 - to SPK in transplant centres in Katowice and Wrocław from 1998 to 2009. QOL was measured using Polish version of Kidney Disease and Quality of Life Short FormTM. Among clinical parameters recipient age, duration of diabetes and duration of dialysis treatment at the time of transplantation, time after transplantation, as well as exogenous insulin independence, creatinine concentration, BMI and vision impairment at the time of observation were considered. Results: Recipients age at the time of transplantation co-related with sexual function (r=-0,57), sleep (r=-0,33), physical functioning (r=-0,40), role physical (r=0,39) and SF-12 Physical Health Composite (r=-0,45). Diabetes duration at the time of transplantation co-related with symptom/problem list (r=0,35), quality of social interaction (r=-0,29), sleep (r=-0,35) and energy/fatigue (r=-0,34). Exogenous insulin independence at the time of observation co-related with effect of kidney disease (r=-0,55), overall health (r=0,46), physical functioning (r=0,45), role physical (r=-0,29), general health (r=0,36), role emotional (r=-0, 36) and SF-12 Mental Health Composite (r=0,38). Creatinine concentration at the time of observation co-related with symptom/problem list (r=0,32) and sexual function (r=-0,56). BMI at the time of observation co-related with physical functioning (r=-0,41), role emotional (r=0,46), energy/fatigue (r=-0,34) and SF-12 Mental Health Composite (r=-0,38). Conclusion: Recipient age and duration of diabetes at the time of transplantation, as well as exogenous insulin independence and BMI at the time of observation are the most important factors that influence QOL of type 1 diabetic patients with ESRD subjected to KTx or SPK in long term follow up.