This study explores the association between kidney function, side effects of immunosuppressive treatment, coping self-efficacy, and physical and mental HRQoL at 3 months (baseline) after kidney transplantation (KT) and their impact on patient and graft survival for up to 10 years (follow-up).
A group of 151 patients provided at baseline their socioeconomic and medical (CKD-EPI) data and completed the End-Stage Renal Disease Symptom Checklist (perceived side effects), the coping self-efficacy scale, and the SF-36. At follow-up, patients’ health status was noted. Univariate GLM exploring the main effects of the independent variables on physical and mental HRQoL was performed; furthermore, Cox regression analyses were performed to determine whether the early posttransplantation factors predicted patient and graft survival.
Less severe side effects of immunosuppressive treatment and higher efficacy in stopping unpleasant emotions were associated with both higher physical and mental HRQoL at baseline. Younger age was associated with higher physical HRQoL and older age, and lower efficacy in getting support from family and friend were associated with higher mental HRQoL. Patients reporting higher physical and mental HRQoL at 3 months and with higher age and better kidney function had higher odds of surviving with a functioning graft.
Older age, higher kidney function, and higher physical and mental HRQoL at baseline significantly improved the odds of graft and patient survival over 10 years. These results show the importance of close monitoring of early posttransplantation HRQoL along with kidney function and reported side effects because of their effect on long-term patient outcomes.
1 Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Safarik University, Kosice, Slovak Republic.
2 Institute of Public Health–Department of Social Medicine, Faculty of Medicine, Safarik University, Kosice, Slovak Republic.
3 Nephrology and Dialysis Centre Fresenius, Kosice, Slovak Republic.
4 Transplantation Department, University Hospital L. Pasteur, Kosice, Slovak Republic.
5 Department of Community and Occupational Health, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
6 Address correspondence to: Lucia Prihodova, M.Sc., Graduate School Kosice Institute for Society and Health, Faculty of Medicine, PJ Safarik University, Tr. SNP 1, Section III, 9th floor, 040 11 Kosice, Slovak Republic.
This work was supported by the Slovak Research and Development Agency under contract No. APVV-0220-10 (80%). Furthermore, this work was supported by the Agency of the Slovak Ministry of the Education, Science, Research and Sport of the Slovak Republic for the Structural Funds of the EU under project No. ITMS: 26220120058 (20%).
The authors declare no conflicts of interest.
L.P. performed the study, collected and analyzed data, and wrote the manuscript. J.R. designed and performed the study and commented on the draft. M.M. performed the study and commented on the draft. I.N. designed the study. R.R., J.P.V., and J.W.G. designed and supervised the study and commented on the draft.
Received 16 September 2013. Revision requested 8 October 2013.
Accepted 8 November 2013.