Gender disparity in health-related quality of life and fatigue after living renal donation

Abstract

BackgroundThe 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.MethodsClinical 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).ResultsTwo 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.ConclusionsOverall, 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.Electronic supplementary materialThe online version of this article (10.1186/s12882-018-1187-8) contains supplementary material, which is available to authorized users.

Transitions in frailty state after kidney transplantation

“…To minimize this risk, patients were given sufficient time to think about their answers and if they were not willing to give a response by phone, they received the questionnaire by mail and were offered a follow-up telephone consultation. Our response rate, using this approach, was 75.5% which is in accordance with other survey studies and resulted in a reliable selection to perform our analyses [38][39][40][41]. Second, the GFI is a self-reported questionnaire.…”

Graft survival differences in kidney transplants related to recipient sex and age

“…There are only a small number of studies, most of them monocentric, like ours, or focused on very specific issues (e.g., biological factors, personal finance, health literacy issues, and living donation) and rarely extended to other geographical locations or health systems ( 15 , 20 , 22 – 24 , 26 ). In addition, it has already been described that health workers have limited ability to identify inequalities related to recipient sex, and these inequalities appear to be more difficult to identify than those related to financial issues, race or health literacy of kidney patients ( 22 , 27 , 28 ). In our study, we did not focus on financial issues because our public health system guarantees access to any treatment for the entire population, and difficulties in obtaining immunosuppressive treatment due to low income, as described for women in other countries or communities, are uncommon ( 14 , 29 , 30 ).…”

Nachsorge bei Lebendnierenspendern

“…Zwar zeigen Nierenlebendspender im Langzeitverlauf anders als im kurzfristigen postoperativen Verlauf kein deutlich erhöhtes Risiko für eine Fatigue-Symptomatik [26]. Es gibt allerdings Hinweise auf ein erhöhtes Risiko für Fatigue bei Lebendnierenspenderinnen zwischen 40 und 59 Jahren [28]. Es sollte insbes.…”