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Trends and predictors of multidimensional health-related quality of life after living donor kidney transplantation

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A Correction to this article was published on 20 July 2020

This article has been updated

Abstract

Purpose

Living donor kidney transplant (LDKT) imparts the best graft and patient survival for most end-stage kidney disease (ESKD) patients. Yet, there remains variation in post-LDKT health-related quality of life (HRQOL). Improved understanding of post-LDKT HRQOL can help identify patients for interventions to maximize the benefit of LDKT.

Methods

For 477 LDKT recipients transplanted between 11/2007 and 08/2016, we assessed physical, mental, social, and kidney-targeted HRQOL pre-LDKT, as well as 3 and 12 months post-operatively using the SF-36, Kidney Disease Quality of Life—Short Form (KDQOL-SF), and the Functional Assessment of Cancer Therapy—Kidney Symptom Index 19 item version (FKSI-19). We then examined trajectories of each HRQOL domain using latent growth curve models (LGCMs). We also examined associations between decline in HRQOL from 3 months to 12 months post-LDKT and death censored graft failure (DCGF) using Cox regression.

Results

Large magnitude effects (d > 0.80) were observed from pre- to post-LDKT change on the SF-36 Vitality scale (d = 0.81) and the KDQOL-SF Burden of Kidney Disease (d = 1.05). Older age and smaller pre- to post-LDKT decreases in serum creatinine were associated with smaller improvements on many HRQOL scales across all domains in LGCMs. Higher DCGF rates were associated with worse physical [e.g., SF-36 PCSoblique hazard ratio (HR) 1.18; 95% CI 1.01–1.38], mental (KDQOL-SF Cognitive Function HR 1.27; 95% CI 1.00–1.62), and kidney-targeted (FKSI-19 HR: 1.18; 95% CI 1.00–1.38) HRQOL domains.

Conclusion

Clinical HRQOL monitoring may help identify patients who are most likely to have failing grafts and who would benefit from post-LDKT intervention.

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Change history

  • 20 July 2020

    In its original publication, an erroneous version of Fig.��2d was included in the manuscript. The corrected figure has now been added.

Abbreviations

BMI:

Body mass index

BUN:

Blood urea nitrogen

CFI:

Comparative fit index

DCGF:

Death-censored graft failure

DDKT:

Deceased donor kidney transplant

ESKD:

End-stage kidney disease

FKSI-19:

Functional Assessment of Cancer Therapy—Kidney Symptom Index 19 item version

HR:

Hazard ratio

HRQOL:

Health-related quality of life

PROMIS:

NIH Patient Reported Outcomes Measurement Information System

KDQOL-SF:

Kidney Disease Quality of Life—Short Form

KT:

Kidney transplantation

LDKT:

Living donor kidney transplant

LGCM:

Latent growth curve model

MCSoblique :

Mental component summary—oblique scoring

PCSoblique :

Physical component summary—oblique scoring

SF-36:

Medical outcomes study short form-36

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Funding

This study was unfunded.

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Authors and Affiliations

  1. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 Michigan Ave, 21st Floor, Chicago, IL, 60611, USA

    John D. Peipert, David Cella, Daniela P. Ladner & Zeeshan Butt

  2. Northwestern University Transplant Outcomes Research Collaborative, Comprehensive Transplant Center, Feinberg School of Medicine, Chicago, IL, USA

    John D. Peipert, Juan Carlos Caicedo, John J. Friedewald, Michael M. I. Abecassis, David Cella, Daniela P. Ladner & Zeeshan Butt

  3. Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Zeeshan Butt

Authors
  1. John D. Peipert
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  2. Juan Carlos Caicedo
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  3. John J. Friedewald
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  4. Michael M. I. Abecassis
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  5. David Cella
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  6. Daniela P. Ladner
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  7. Zeeshan Butt
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Contributions

JDP conceived of the study concept, conducted data analysis, and led the manuscript writing. ZB and DPL conceived of the study concept and participated in manuscript writing. JJC, JJF, MMIA, and DC participated in manuscript writing.

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Correspondence to John D. Peipert.

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Peipert, J.D., Caicedo, J.C., Friedewald, J.J. et al. Trends and predictors of multidimensional health-related quality of life after living donor kidney transplantation. Qual Life Res 29, 2355–2374 (2020). https://doi.org/10.1007/s11136-020-02498-2

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