Tacrolimus is increasingly used as a baseline immunosuppressant after renal transplantation. This multicentre study assessed healthrelated quality of life and symptom experience in renal transplant patients on tacrolimus-based therapy, using the SF-36 and Euroqol 5 dimensions (EQ-SD) and the 'modified transplant symptom occurrence and symptom distress scale', respectively. Symptoms of depression were assessed with the short form of the Beck Depression Inventory and physical activity with the Baecke questionnaire. Overall, 350 patients with a median post-transplant status of 16.7 months were enrolled. Results revealed that patients experienced lower SF-36 scores than the general population, except in terms of bodily pain. Univariate and multivariate analyses demonstrated that a higher degree of depressive symptoms and female gender were consistently related to a health status perceived as being worse and a higher rate of symptom experience. These findings are in accordance with previous quality-of-life reports that assessed patients under various immunosuppressive therapies. Therefore, interventions, including the screening and treatment for depression and the addressing of gender-specific issues, can enhance quality of life.

Summary Kidney biopsy can result in bleeding complications. Prebiopsy testing using bleeding time (BT) is controversial. New whole blood haemostasis tests, such as platelet function analyser‐100 (PFA‐100) and multiple electrode aggregometry (MEA), might perform better. We postulated that PFA‐100 would be suitable to replace BT prebiopsy. In 154 patients, transplanted kidney biopsies were performed after measurement of bleeding time, PFA‐100, MEA and mean platelet volume (MPV). Bleeding outcome (haemoglobin (Hb) drop, haematuria (±bladder catheterization), ultrasound finding of a bleeding, need for (non)surgical intervention and/or transfusion) after the biopsy was correlated to each test. Male–female ratio was 2:1. 50% had a surveillance biopsy at either three or 12 months. Around 17% (had) used acetylsalicylic acid (ASA) prebiopsy. Of 17 bleeding events, one subject needed a transfusion. Most bleeding events were Hb reductions over 1 mmol/l and all resolved uneventful. BT, PFA‐100, MEA and MPV did not predict a bleeding outcome; prior ASA use however could (odds ratio 3.19; 95%‐CI 1.06 to 9.61). Diagnostic performance data and Bland–Altman analysis showed that BT could not be substituted by PFA‐100. ASA use was the best determinant of bleeding after kidney biopsy. Routine haemostasis testing prebiopsy has no added value.

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Tacrolimus is increasingly used as a baseline immunosuppressant after renal transplantation. This multicentre study assessed healthrelated quality of life and symptom experience in renal transplant patients on tacrolimus-based therapy, using the SF-36 and Euroqol 5 dimensions (EQ-SD) and the 'modified transplant symptom occurrence and symptom distress scale', respectively. Symptoms of depression were assessed with the short form of the Beck Depression Inventory and physical activity with the Baecke questionnaire. Overall, 350 patients with a median post-transplant status of 16.7 months were enrolled. Results revealed that patients experienced lower SF-36 scores than the general population, except in terms of bodily pain. Univariate and multivariate analyses demonstrated that a higher degree of depressive symptoms and female gender were consistently related to a health status perceived as being worse and a higher rate of symptom experience. These findings are in accordance with previous quality-of-life reports that assessed patients under various immunosuppressive therapies. Therefore, interventions, including the screening and treatment for depression and the addressing of gender-specific issues, can enhance quality of life.