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Comparison of longitudinal quality of life outcomes in preemptive and dialyzed patients on waiting list for kidney transplantation

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Abstract

Purpose

The waiting list period for kidney transplantation can be lengthy and associated with a deteriorated health-related quality of life (HRQoL). It might also be experienced differently depending on the experience of renal replacement therapy (preemptive or dialyzed patients), and the type of dialysis. The main objective of this study is to measure and compare HRQoL changes in preemptive, hemodialysis (HD), and peritoneal dialysis (PD) patients during the waiting list period for kidney transplantation.

Methods

A sample of adult patients on kidney transplant waiting list from three French University Hospital centers was recruited. HRQoL was measured using the SF-36 and a specific questionnaire (ReTransQol), which were collected every 6 months before transplantation in preemptive, HD, and PD patients. Mixed-effects models taking into account time and possible confounding factors were used to compare HRQoL changes between the three groups.

Results

Preemptive (n = 230), HD (n = 177), and PD patients (n = 39) were enrolled. The renal replacement therapy modalities, time (time on waiting list and age at registration), and gender were associated with HRQoL changes. The HD and PD patients had a significantly lower perceived HRQoL on Role Physical, Social Functioning, and Role Emotional dimensions than the preemptive patients, with lower scores for PD compared to HD patients. The HRQoL scores of all patients were lower compared to the French general population for all dimensions.

Conclusions

A better understanding of pre-transplantation patients’ experience can help improving patient care with adapted educational programs and psychological support depending on the type of renal replacement therapy.

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Acknowledgements

The study has received ethics approval and is supported by a grant from the French Ministry of Health (PHRC-13-0224, 2013). The authors express sincere thanks to Elodie Faurel-Paul and Astrid Fleury for their assistance for the study, as well as all the participants for their contribution to the study.

Author information

Authors and Affiliations

  1. UMR INSERM 1246, SPHERE “MethodS in Patient-centered outcomes and HEalth ResEarch”, Université de Nantes, Université de Tours, 22 Boulevard Benoni Goullin, Nantes, France

    Line Auneau-Enjalbert, Jean-Benoit Hardouin, Myriam Blanchin & Véronique Sébille

  2. Plateforme de Méthodologie et Biostatistique, CHU Nantes, Nantes, France

    Line Auneau-Enjalbert, Jean-Benoit Hardouin & Véronique Sébille

  3. Centre de Recherche en Transplantation et Immunologie INSERM, UMR1064, Université de Nantes, Centre Hospitalier Universitaire de Nantes, RTRS «Centaure», Nantes, France

    Magali Giral & Aurélie Meurette

  4. Néphrologie, Transplantation et Immunologie Clinique, Hôpital Edouard Herriot, Lyon, France

    Emmanuel Morelon

  5. Service de Néphrologie, Hôpital Pasteur, Nice, France

    Elisabeth Cassuto

Authors
  1. Line Auneau-Enjalbert
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  8. Véronique Sébille
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Contributions

LA analyzed the data and drafted the paper; JBH, MB, and VS supervised the work and revised the paper; MG, AM, EM, and EC revised the paper; all authors approved the final version of the manuscript.

Corresponding author

Correspondence to Véronique Sébille.

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All authors declared that they have no competing interest.

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Auneau-Enjalbert, L., Hardouin, JB., Blanchin, M. et al. Comparison of longitudinal quality of life outcomes in preemptive and dialyzed patients on waiting list for kidney transplantation. Qual Life Res 29, 959–970 (2020). https://doi.org/10.1007/s11136-019-02372-w

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