Impact of personality and psychological distress on health-related quality of life in kidney transplant recipients

Abstract

Summary Health‐related quality of life (HRQoL) has become an important outcome in the evaluation of kidney transplantation (KT). Although the medical and sociodemographic predictors of HRQoL in patients after KT are well known, there is still a lack of knowledge about the psychological factors involved. This study focuses on the role of personality and actual psychological distress in predicting HRQoL after KT. Sociodemographic (gender, age, education, average income), medical (glomerular filtration, serum albumin, number of co‐morbid diseases) and psychological data (neuroticism, extroversion, psychological distress) were collected from 177 (60.5% male subjects; 48 ± 12.1 years) kidney transplant recipients, and physical and mental HRQoL were measured using the SF‐36. A univariate general linear model analysis was performed. Higher physical HRQoL was associated with younger age, higher education and income, a low number of co‐morbid diseases, lower neuroticism and distress. Higher mental HRQoL was associated with higher education and income, longer time from KT, higher extroversion, lower neuroticism and distress. In both physical and mental HRQoL, actual distress was the best predictor, even when controlled for neuroticism. These results confirm the importance of psychological distress in patients and its impact on their HRQoL after KT and can be applied in intervention programs focused on increasing HRQoL.

Factores asociados a calidad de vida relacionada con la salud de pacientes trasplantados de riñón

“…Mayores ingresos económicos y pacientes con renta más alta se correlaciona con mejor percepción de su estado físico y mayor CVRS mental 22,29 . La mayoría de los receptores no observan diferencias en cuanto a los ingresos económicos tras el injerto 89'2%, 9'2% tuvieron ingresos superiores tras la intervención y 1'5% los vieron disminuidos, según un artículo35.…”

“…Sin embargo, el neuroticismo solo tiene correlación negativa con la función física (4'4%) y el dolor corporal (4'8%). De manera que cuanto menor sea el neuroticismo y la angustia psicológica mayor CVRS 22 …”

“…Más tiempo post trasplante indica mejor CVRS mental debido a una mejor adaptación y buen funcionamiento del injerto 22,26 . Sin embargo, hay estudios que recogen esta variable con una correlación negativa con la CVRS y el componente mental, asociando menos tiempo trasplantado con mayor CVRS (puntuación media=48'74), más tiempo trasplantado con menor CVRS puesto que aumentan los síntomas físi-cos, la incertidumbre, fatiga y miedo (puntuación media=46'06) 23,39 .…”

“…Esta variabilidad se explica sobre todo por los factores que afectan a CVRS después del TR, entre las cuales las variables sociodemográficas y médicas son las más frecuentemente investigadas. Existen además estudios que han investigado acerca de las variables psicosociales confirmando que el afecto negativo, rasgos de personalidad y la angustia intervienen en la percepción de los síntomas y la estimación de la CVRS de estos pacientes 22 …”

Chronic renal insufficiency does not induce behavioral and cognitive alteration in rats

“…CKD represents a serious public health problem worldwide: increasing incidence and prevalence of CKD imposes burden on the utilization of medical care for CKD itself as well as increase in costs of treating complications from CKD [2]. In humans, one of the most sensitive complications, severely decreasing the quality of life, is the cognitive decline [3,4]. Several studies examining the link between the CKD and cognitive outcomes revealed higher rates of dementia and cognitive dysfunction when compared to those in general population [5,6].…”