Division of Nephrology, Medical University Hospital Heidelberg, Im Neuenheimer Feld 162, 69120, Heidelberg, Germany.
Department of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 410, D-69120, Heidelberg, Germany.
BMC Nephrol. 2018 Dec 27;19(1):377. doi: 10.1186/s12882-018-1187-8.
The clinical outcome and health-related quality of life (HRQoL) of living kidney donors is mostly not detrimental, but some donors experience impairment after donation. Gender-specific effects of living kidney donors was evaluated.
Clinical outcome was assessed in living kidney donors and HRQoL was obtained by self-reporting validated test systems as the Multidimensional Fatigue Inventory (MFI-20), the Short Form 36 (SF-36), and the Patient Health Questionnaire (PHQ-9).
Two hundred and eleven (211) living renal donors were evaluated (female 62.2%). Response rate was 80.8%. In both genders, a decrease of renal function of 26% was observed after donation. De novo antihypertensives were introduced in 28.3% of women and 36.5% of men. HRQoL was comparable in female and male donors, except for mental HRQoL, which was lower in 51- to 60-year-old female donors, compared to age-matched male donors and to the female general population. Female donors aged 40-59 years demonstrated more fatigue than the age-matched general population. A low mental HRQoL (MCS; SF-36) was associated with higher values for fatigue (General Fatigue Score; MFI-20) in both genders. Multiple regression analysis detected the General Fatigue score of the MFI-20 questionnaire and depression identified by the PHQ-9 score as independent variables predicting MCS of the SF-36 in both genders. Lower age at time of donation contributed to a lower MCS in female donors.
Overall, HRQoL in living kidney donors exceeds that of the general population. Inferior mental health status and fatigue seem to be a problem, especially in middle-aged female donors, but not in all female donors. Psychological evaluation pre donation and psychological support post donation are required.
活体肾捐献者的临床结局和健康相关生活质量（HRQoL）大多没有受到损害，但有些捐献者在捐献后会出现功能障碍。本研究评估了活体肾捐献者的性别特异性影响。
通过自我报告的多维疲劳量表（MFI-20）、健康调查简表 36（SF-36）和患者健康问卷（PHQ-9）等经过验证的测试系统，评估了活体肾捐献者的临床结局和 HRQoL。
共评估了 211 名（62.2%为女性）活体肾捐献者，应答率为 80.8%。在两种性别中，均观察到捐献后肾功能下降 26%。28.3%的女性和 36.5%的男性新引入了抗高血压药物。女性和男性捐献者的 HRQoL 相当，除了心理健康方面，51-60 岁女性捐献者的心理健康明显低于同龄男性捐献者和女性一般人群。40-59 岁的女性捐献者比同龄一般人群表现出更多的疲劳。MFI-20 问卷的一般疲劳评分和 PHQ-9 评分确定的抑郁与女性和男性的 SF-36 的 MCS 呈负相关。多因素回归分析显示，MFI-20 问卷的一般疲劳评分和 PHQ-9 评分确定的抑郁是女性和男性 SF-36 的 MCS 的独立预测因子。捐赠时年龄较小会导致女性捐献者的 MCS 较低。
总体而言，活体肾捐献者的 HRQoL 高于一般人群。心理健康状况较差和疲劳似乎是一个问题，尤其是在中年女性捐献者中，但并非所有女性捐献者都存在这一问题。需要在捐赠前进行心理评估，并在捐赠后提供心理支持。
