Changes in health‐related quality of life in older candidates waiting for kidney transplantation

Lønning, Kjersti; Midtvedt, Karsten; Bernklev, Tomm; Brunborg, Cathrine; Andersen, Marit Helen; Lippe, Nanna von der; Reisæter, Anna Varberg; Line, Pål–Dag; Hartmann, Anders; Heldal, Kristian

doi:10.1111/nep.13117

Cited by 14 publications

(24 citation statements)

References 28 publications

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“…We have previously reported a decrease in HRQoL while the patients were on the waiting list. 13 Time in dialysis was associated with reduced HRQoL scores and has been shown to be a risk factor for impaired HRQoL after KTx in nonelderly recipients 28 and also a risk factor for mortality in older recipients. 29 This may indicate that suitable patients should be transplanted as early as possible while preemptive or at least in the start of dialysis treatment.…”

Section: Discussionmentioning

confidence: 95%

“… 30 , 31 At our center, the average waiting time for deceased donor KTx has been relatively short (15 months for 1st KTx), and this may have contributed to the good overall HRQoL we report in this population. Dialysis treatment is also known to have a negative impact on social life 32 and one of our expectations was that the patients' social life, which decreased during waiting time, 13 would benefit from transplantation. To our surprise, this did not happen even though other domains as VT, effect, and BKD improved.…”

Section: Discussionmentioning

confidence: 99%

“…Information regarding preenlisting evaluation of KTx candidates and distribution of HRQoL questionnaires before KTx has been described previously. 13 …”

Section: Methodsmentioning

confidence: 99%

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Improved Health-Related Quality of Life in Older Kidney Recipients 1 Year After Transplantation

Lønning

Heldal

Bernklev

et al. 2018

Transplantation Direct

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BackgroundWe aimed to evaluate changes in health-related quality of life (HRQoL) in patients 65 years or older from time of kidney transplantation (KTx) until 1 year postengraftment.MethodsA single-center prospective study was conducted. HRQoL was measured pre-KTx and at 2, 6, and 12 months postengraftment using self-reported Kidney Disease and Quality of Life short-form version 1.3. Intraindividual scores before and after KTx were evaluated. Liu Comorbidity Index was registered at enlisting. short-form-36 scores were additionally compared with scores from an age-matched population.ResultsFrom January 1, 2013, until November 30, 2016, a total of 289 waitlisted patients were included. By September 1, 2017, 134 had reached 1 year postengraftment, and valid questionnaires were available in 120 (90%) patients. Mean age at KTx was 71.6 years (±4.3 years), 71% were male. Living donor was used in 21%, and preemptive KTx was performed in 30% of the recipients. Median waiting time for KTx from deceased donor was 16 months (range, 0.6-50.5 months). A total of 79 (66%) recipients had a Liu Comorbidity Index score of 3 or less.All HRQoL scores except the domain social function improved at 2 months postengraftment and remained stable or continued to improve at 1 year.HRQoL scores 12 months postengraftment were similar to those described in an age-matched general population except for the domain social function which remained at a significantly lower level. Time in dialysis was the most important variable associated with impaired HRQoL postengraftment.ConclusionsHRQoL scores showed clinically significant improvement in older KTx recipients 1 year posttransplant.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Improved Health-Related Quality of Life in Older Kidney Recipients 1 Year After Transplantation

Lønning

Heldal

Bernklev

et al. 2018

Transplantation Direct

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“…Informants were included consecutively from an ongoing multimethod study that explores health-related quality of life in KTx candidates ≥65 years. 11 Patients who did not understand the Norwegian language or had cognitive dysfunction were excluded. Cognitive dysfunction was investigated as part of the pre-enlisting evaluation.…”

Section: Methodsmentioning

confidence: 99%

“… 7 8 Knowledge of health-related quality of life in older kidney transplant recipients is limited, 9 10 even though a few recent studies have focused on older candidates and recipients. 11 12 Older patients’ thoughts about their situation awaiting a kidney transplant should be investigated. 13 …”

Section: Introductionmentioning

confidence: 99%

Older kidney transplantation candidates’ expectations of improvement in life and health following kidney transplantation: semistructured interviews with enlisted dialysis patients aged 65 years and older

et al. 2018

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ObjectiveThe aim was to study the expectations of improvement in life and health following kidney transplantation (KTx) in a population of wait-listed patients ≥65 years with end-stage kidney disease.DesignQualitative research with individual in-depth interviews.SettingPatients on dialysis enlisted for a KTx from a deceased donor were included from an ongoing study of older patients’ perspectives on KTx. Qualitative face-to-face interviews were conducted in a safe and familiar setting, and were analysed thematically using the theoretical framework of lifespan.InformantsFifteen patients (median age 70 years, range 65–82) from all parts of Norway were interviewed. Informants were included consecutively until no new information was gained.ResultsTwo main themes were evident: receiving a kidney is getting life back and grasp the chance. In addition, the themes ‘hard to loose capacity and strength’, ‘reduced freedom’ and ‘life on hold’ described the actual situation and thereby illuminated the informants’ expectations. The informants tried to balance positive expectations and realism towards KTx, and they were hoping to become free from dialysis and to live a normal life.ConclusionThis study shows that older KTx candidates comprise a heterogeneous group of patients who take individual approaches that allow them to maintain autonomy and control while waiting for a transplant. This study provides new knowledge about the older KTx candidates relevant for clinicians, patients and researchers.

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Kidney Transplant in Elderly

Petraglia

Heldal

2019

Clinical Nephrogeriatrics

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Changes in health‐related quality of life in older candidates waiting for kidney transplantation

Abstract: HRQoL in older patients waiting for kidney transplantation decreases during the first year on the waiting list, but only the change in social function is clinically significant.

Cited by 14 publications

References 28 publications

Improved Health-Related Quality of Life in Older Kidney Recipients 1 Year After Transplantation

Improved Health-Related Quality of Life in Older Kidney Recipients 1 Year After Transplantation

Older kidney transplantation candidates’ expectations of improvement in life and health following kidney transplantation: semistructured interviews with enlisted dialysis patients aged 65 years and older

Kidney Transplant in Elderly

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