Health Related Quality of Life in Renal Transplantation and Related Parameters

INTRODUCTION: Renal transplantation is the optimal treatment in end-stage renal disease (ESRD). Even after succesfull renal transplantation, the health related quality of life (HRQoL) might be affected adversely by the long term complications of the primary disease. Additionally, immunosupressive treatment itself, adverse effects of the drugs have effect on HRQoLof patients, causing stress. HRQoL measurements in transplant patients are important in reflecting the success of immunosupressive treatment, patient compliance and graft function. The main objective of this study is to assess HRQoL in renal transplant patients and to determine the variables affecting it. METHODS: This study was performed in nephrology department. 80 renal transplant patients, 42 hemodialysis patients and 35 healthy volunteers were included in the study. The patients were evaluated by KDQoL–SF questionnaire consisting of 38 questions answered by patients on their own. The healthy volunteers were evaluated with SF–36 health quality questionnaire. RESULTS: There was a statistically significant correlation between the quality of life scores and younger age, adequate social support, comorbid factors, hospital admissions within last six months, number of medications used, serum albumin, haemoglobin levels and the duration of dialysis treatment. Good graft function was considered to be the most important parameter influencing the HRQoL scores. DISCUSSION AND CONCLUSION: Younger age, adequate social support, higher albumin and haemoglobin levels are positive predictives of better HRQoL scores. Presence of comorbid factors, hospital admissions, polypharmacy, longer duration of dialysis treatment are negative predictives of lower HRQoL scores. Periodic assesment of HRQoL should be included in the follow-up protocols of transplant patients.

Böbrek Naklinde Sağlık İlişkili Yaşam Kalitesi ve İlgili Parametreler

GİRİŞ ve AMAÇ: Böbrek nakli son dönem böbrek yetmezliğinde (SDBY) en uygun ve iyi tedavi seklidir. Ancak başarılı böbrek transplantasyonundan sonra bile, hastaligin uzun vadeli etkileri ve komplikasyonlar sağlıkla ilişkili yaşam kalitesini (HRQoL) olumsuz etkilemektedir. Ek olarak immünosupresif tedavi ve yan etkileri, transplantasyonun kısa ve uzun dönem komplikasyonları hastalarin yasam kalitesini olumsuz etkilemektedir. Nakil hastalarında HRQoL ölçümleri, immünosupresif tedavi, hasta uyumu ve greft fonksiyonunun başarısını dolayli olarak göstermektedir. Bu çalışmanın temel amacı böbrek nakli hastalarında yasam kalitesini değerlendirmek ve etkileyen değişkenleri belirlemektir. YÖNTEM ve GEREÇLER: Bu çalışma nefroloji bölümünde takipli 80 böbrek nakli hastası, 42 hemodiyaliz hastası ve 35 sağlıklı gönüllü çalışmaya dahil edildi. Hastalar kendilerince doldurulan 38 sorudan oluşan KDQoL- SF anketi ile değerlendirildi. Sağlıklı gönüllüler SF- 36 sağlık kalitesi anketi ile değerlendirildi. BULGULAR: Yaşam kalitesi skorları ile genç yaş, yeterli sosyal destek, komorbid faktörler, son altı ay içinde hastaneye başvurular, kullanılan ilaç sayısı, serum albümin, hemoglobin düzeyleri ve diyaliz tedavisi süresi arasında istatistiksel olarak anlamlı bir ilişki buundu. İyi greft fonksiyonu HRQoL skorlarını etkileyen en önemli parametre olarak kabul edildi. TARTIŞMA ve SONUÇ: Genç yaş, yeterli sosyal destek, daha yüksek albümin ve hemoglobin düzeyleri HRQoL skorlarının daha iyi olduğunu göstermektedir. Eşlik eden faktörlerin varlığı, hastaneye yatışlar, çoklu ilaç kullanımı, diyaliz tedavisinin daha uzun sürmesi, düşük HRQoL skorlarının negatif belirtecleridir. Nakil hastalarının takiplerine periyodik HRQoL değerlendirmesi dahil edilmelidir.

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