Hamasaki Yuko, Yamaguchi Tetsuo, Takahashi Yusuke, Hashimoto Junya, Muramatsu Masaki, Kawamura Takeshi, Sakai Ken, Shishido Seiichiro, Tazaki Miyako
Department of Pediatric Nephrology, Toho University Faculty of Medicine, 6-11-1, Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan.
Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan.
Clin Exp Nephrol. 2018 Oct;22(5):1198-1204. doi: 10.1007/s10157-018-1604-0. Epub 2018 Jul 6.
Caregivers of patients with chronic kidney disease experience great burdens. Changes in these caregivers' quality of life (QOL) before and after their children underwent kidney transplantation (KTx) were evaluated in this prospective study.
The sequential QOL scores of 31 caregivers (median age 38.5 years) whose children (5.8 years) underwent KTx from 2012 to 2014 were studied. The same questionnaires were administered before and 1, 3, and 12 months after KTx. We evaluated whether the following factors were associated with QOL: pre-transplant dialysis, recipient's mental and/or motor disability, and acute rejection or infections after KTx.
The average QOL score before KTx (3.40) was higher than that of the general population (3.23). Despite a temporal decrease at 1 month (3.15), the final QOL scores were maintained at 3 months (3.40) and 1 year (3.42) after KTx. The mean QOL scores were significantly higher for caregivers of patients with than without dialysis before KTx [3.46 vs. 3.28 (p = 0.041) at 3 months and 3.53 vs. 3.18 (p = 0.001) at 1 year, respectively]. Conversely, these scores were significantly lower for caregivers of patients with than without disabilities [2.97 vs. 3.20 (p = 0.021) at 1 month, 3.18 vs. 3.46 (p = 0.006) at 3 months, and 3.10 vs. 3.50 (p = 0.001) at 1 year, respectively].
Dialysis of children before KTx was a particularly larger burden for caregivers. The child's comorbidities and social adaptation problems might be focused after KTx, we need to evaluate for more long-term QOL of caregivers.
慢性肾病患者的照料者负担沉重。本前瞻性研究评估了这些照料者在其子女接受肾移植（KTx）前后生活质量（QOL）的变化。
研究了2012年至2014年间其子女（5.8岁）接受KTx的31名照料者（中位年龄38.5岁）的连续QOL评分。在KTx前以及KTx后1、3和12个月发放相同的问卷。我们评估了以下因素是否与QOL相关：移植前透析、受者的精神和/或运动残疾以及KTx后的急性排斥反应或感染。
KTx前的平均QOL评分为（3.40），高于一般人群（3.23）。尽管在1个月时出现暂时下降（3.15），但最终QOL评分在KTx后3个月（3.40）和1年（3.42）时得以维持。KTx前接受透析的患者的照料者的平均QOL评分在3个月时[分别为3.46对3.28（p = 0.041）]和1年时[分别为3.53对3.18（p = 0.001）]显著高于未接受透析患者的照料者。相反，有残疾患者的照料者的这些评分在1个月时[分别为2.97对3.20（p = 0.021）]、3个月时[分别为3.18对3.46（p = 0.006）]和1年时[分别为3.10对3.50（p = 0.001）]显著低于无残疾患者的照料者。
KTx前儿童的透析对照料者来说负担尤其大。KTx后可能需要关注儿童的合并症和社会适应问题，我们需要评估照料者更长期的QOL。
