TY - JOUR
T1 - Frailty and Postkidney Transplant Health-Related Quality of Life
AU - McAdams-DeMarco, Mara A.
AU - Olorundare, Israel O.
AU - Ying, Hao
AU - Warsame, Fatima
AU - Haugen, Christine E.
AU - Hall, Rasheeda
AU - Garonzik-Wang, Jacqueline M.
AU - Desai, Niraj M.
AU - Walston, Jeremy D.
AU - Norman, Silas P.
AU - Segev, Dorry L.
N1 - Funding Information:
This study was supported by NIH grant K24DK101828 (PI: Dorry Segev), and by NIH grant R01 AG042504 (PI: Dorry Segev). Mara McAdams-DeMarco was supported by the Johns Hopkins University Claude D. Pepper Older Americans Independence Center (P30AG021334) and NIH grants K01AG043501 and R01AG055781. Rasheeda Hall was supported by the Duke Claude D. Pepper Older Americans Independence Center (P30AG028716), GEMSSTAR program R03AG050834], National Center for Advancing Translational Sciences (UL1TR001117), the T. Franklin Williams Scholarship Award (Funding provided by Atlantic Philanthropies, Inc., the John A. Hartford Foundation, the Alliance for Academic Internal
Funding Information:
Medicine-Association of Specialty Professors, and the American Society of Nephrology Foundation). Christine Haugen was supported by NIH grant F32AG053025.
Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Background Health-related quality of life (HRQOL) reflects a patient's disease burden, treatment effectiveness, and health status and is summarized by physical, mental, and kidney disease-specific scales among end-stage renal disease patients. Although on average HRQOL improves postkidney transplant (KT), the degree of change depends on the ability of the patient to withstand the stressor of dialysis versus the ability to tolerate the intense physiologic changes of KT. Frail KT recipients may be extra vulnerable to either of these stressors, thus affecting change in HRQOL after KT. Methods We ascertained frailty, as well as physical, mental, and kidney disease-specific HRQOL in a multicenter prospective cohort of 443 KT recipients (May 2014 to May 2017) using Kidney Disease Quality of Life Instrument Short Form. We quantified the short-Term (3 months) rate of post-KT HRQOL change by frailty status using adjusted mixed-effects linear regression models. Results Mean HRQOL scores at KT were 43.3 (SD, 9.6) for physical, 52.8 (SD, 8.9) for mental, and 72.6 (SD, 12.8) for kidney disease-specific HRQOL; frail recipients had worse physical (P < 0.001) and kidney disease-specific HRQOL (P = 0.001), but similar mental HRQOL (P = 0.43). Frail recipients experienced significantly greater rates of improvement in physical HRQOL (frail, 1.35 points/month; 95% confidence interval [CI], 0.65-2.05; nonfrail, 0.34 points/month; 95% CI,-0.17-0.85; P = 0.02) and kidney disease-specific HRQOL (frail, 3.75 points/month; 95% CI, 2.89-4.60; nonfrail, 2.41 points/month; 95% CI, 1.78-3.04; P = 0.01), but no difference in mental HRQOL (frail, 0.54 points/month; 95% CI,-0.17-1.25; nonfrail, 0.46 points/month; 95% CI,-0.06-0.98; P = 0.85) post-KT. Conclusions Despite decreased physiologic reserve, frail recipients experience improvement in post-KT physical and kidney disease-specific HRQOL better than nonfrail recipients.
AB - Background Health-related quality of life (HRQOL) reflects a patient's disease burden, treatment effectiveness, and health status and is summarized by physical, mental, and kidney disease-specific scales among end-stage renal disease patients. Although on average HRQOL improves postkidney transplant (KT), the degree of change depends on the ability of the patient to withstand the stressor of dialysis versus the ability to tolerate the intense physiologic changes of KT. Frail KT recipients may be extra vulnerable to either of these stressors, thus affecting change in HRQOL after KT. Methods We ascertained frailty, as well as physical, mental, and kidney disease-specific HRQOL in a multicenter prospective cohort of 443 KT recipients (May 2014 to May 2017) using Kidney Disease Quality of Life Instrument Short Form. We quantified the short-Term (3 months) rate of post-KT HRQOL change by frailty status using adjusted mixed-effects linear regression models. Results Mean HRQOL scores at KT were 43.3 (SD, 9.6) for physical, 52.8 (SD, 8.9) for mental, and 72.6 (SD, 12.8) for kidney disease-specific HRQOL; frail recipients had worse physical (P < 0.001) and kidney disease-specific HRQOL (P = 0.001), but similar mental HRQOL (P = 0.43). Frail recipients experienced significantly greater rates of improvement in physical HRQOL (frail, 1.35 points/month; 95% confidence interval [CI], 0.65-2.05; nonfrail, 0.34 points/month; 95% CI,-0.17-0.85; P = 0.02) and kidney disease-specific HRQOL (frail, 3.75 points/month; 95% CI, 2.89-4.60; nonfrail, 2.41 points/month; 95% CI, 1.78-3.04; P = 0.01), but no difference in mental HRQOL (frail, 0.54 points/month; 95% CI,-0.17-1.25; nonfrail, 0.46 points/month; 95% CI,-0.06-0.98; P = 0.85) post-KT. Conclusions Despite decreased physiologic reserve, frail recipients experience improvement in post-KT physical and kidney disease-specific HRQOL better than nonfrail recipients.
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U2 - 10.1097/TP.0000000000001943
DO - 10.1097/TP.0000000000001943
M3 - Article
C2 - 28885489
AN - SCOPUS:85041607000
VL - 102
SP - 291
EP - 299
JO - Transplantation
JF - Transplantation
SN - 0041-1337
IS - 2
ER -