Dipartimento di Medicina del Lavoro, Clinica del Lavoro L Devoto-Divisione di Ergonomia e Psicologia del Lavoro, Università degli Studi di Milano, Via San Barnaba 8, Milan, Italy.
Qual Life Res. 2011 Dec;20(10):1689-98. doi: 10.1007/s11136-011-9905-8. Epub 2011 Apr 11.
We sought to determine the association between health-related quality of life (HRQOL) and graft function in renal transplant recipients.
We enrolled 577 kidney transplant recipients aged 18-74 years (response rate 87%). Recipients with multiple or multi-organ transplantation, creatine kinase >200 U/L, acute renal failure or cellular rejection (n = 64), and without creatinine assessments in 3 months pre-enrollment (n = 127) were excluded. The questionnaire included Euro QOL 5 Dimensions (EQ-5D), Health Utility Index III (HUI-III), Kidney Disease Quality of Life-36 (KDQOL36) which include a generic section (RAND SF-12). Data on medical conditions, therapy regimens, and biochemistry results were extracted from clinical charts. We used general linear models adjusted for demographic, socioeconomic, and clinical characteristics to assess the association between HRQOL and severity of chronic kidney disease (CKD).
Patients with more advanced CKD were more likely to be African-American, covered by public insurance, more likely to have shorter time after transplantation, higher phosphorus and lower hemoglobin, serum albumin, and calcium levels. All HRQOL scales were inversely associated with CKD severity. All associations were robust to adjustment for possible confounders.
Several health-related quality of life dimensions may be affected by poor renal function after transplantation.
我们旨在探讨肾移植受者健康相关生活质量（HRQOL）与移植物功能之间的关系。
我们纳入了 577 名年龄在 18-74 岁之间的肾移植受者（应答率为 87%）。排除了接受过多次或多器官移植、肌酸激酶>200U/L、急性肾功能衰竭或细胞排斥反应（n=64）、以及在入组前 3 个月内无肌酐评估的受者（n=127）。问卷包括欧洲五维健康量表（EQ-5D）、健康效用指数 III（HUI-III）、肾脏病生活质量量表-36（KDQOL36），其中包括一般部分（RAND SF-12）。从临床图表中提取有关医疗状况、治疗方案和生化结果的数据。我们使用经过调整的一般线性模型，以评估 HRQOL 与慢性肾脏病（CKD）严重程度之间的关联，该模型调整了人口统计学、社会经济和临床特征。
CKD 更严重的患者更有可能是非洲裔美国人，接受公共保险，移植后时间更短，磷水平更高，血红蛋白、血清白蛋白和钙水平更低。所有 HRQOL 量表均与 CKD 严重程度呈负相关。所有关联在调整可能的混杂因素后仍然稳健。
几个健康相关的生活质量维度可能会受到移植后肾功能不佳的影响。
