Health Related Quality of Life among ESRD Patients on Hemodialysis and Kidney Transplant Recipients: A Comparative Study

Abstract

CKD-5 treatment is expensive and inaccessible for the majority of the Pakistani population. QOL is a valuable research tool in assessing the outcome of therapeutic interventions in chronic diseases. Unfortunately, there is no information available on the QOL in CKD-5 patients in Pakistan. In this present study, we sought to compare the difference between the quality of life in hemodialysis patients and kidney transplant recipients. The study was conducted on hemodialysis patients and kidney transplant recipients at Pakistan Kidney and Liver Institute and Research Centre (PKLI&RC). The study subjects were selected by Convenient Sampling. A comparative study was done to assess the HRQOL between hemodialysis and renal transplant recipients. The Urdu version of the WHOQOL-BREF was used. The mean score of items within all 4 domains was used to calculate the domain score. Descriptive analysis included calculation of frequency, percentage and mean for presentation of socio-demographic and WHOQOL-BREF scores in hemodialysis patients and kidney transplant recipients. The sociodemographic characteristics were significantly different between the two groups. KTRs were younger than HD patients and were generally more educated. A larger number of people in the hemodialysis group as compared to those in the KTR group were found to be unemployed. Patients in KTR group had a much better perception of quality of life (77.5 vs 58) and health (85 vs 63.5) as compared to the hemodialysis patients. KTRs had significantly higher HRQOL scores than HD patients in all 4 domains with the greatest difference seen in physical domain. KTRs also reported fewer ER visits and hospitalizations. The QOL scores of KTRs were better than hemodialysis patients in all four domains: Physical, psychological, social relationship, environmental health. Hence, renal transplant services should be encouraged for people with ESRD and should be made easily available to patients.

Is Lack of Consensus on the Management of Chronic Active Antibody-Mediated Rejection Harming Renal Transplant Recipients?

“…For patients with end-stage renal disease, kidney transplantation offers significantly improved quality of life compared with maintenance haemodialysis. 11 Unfortunately, advancements enabling the transplantation of highly sensitised patients with or without preformed DSA(s) are being held back by significant variations in CABMR surveillance and management across Europe. Expert consensus is the critical next step to reducing the burden of transplant rejection.…”