Renal Transplant Acceptance Status, Health‐related Quality of Life and Depression in Dialysis Patients

Østhus, Tone Brit Hortemo; Preljevic, Valjbona; Sandvik, Leiv; Dammen, Toril; Os, Ingrid

doi:10.1111/j.1755-6686.2011.00254.x

Cited by 6 publications

(4 citation statements)

References 42 publications

(39 reference statements)

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“…The full texts of the remaining 80 articles were retrieved and assessed for eligibility. A total of 35 articles were excluded for the following reasons: comparison group other than in-center HD, 48 , 49 , 50 groups were not separately presented, 51 , 52 , 53 , 54 , 55 unspecified HRQoL questionnaire, 56 , 57 , 58 , 59 HRQoL data exclusively presented in graphs, 60 , 61 , 62 unclear calculation of HRQoL scores, 63 , 64 and outdated population data (data collected before 2007). 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 The studies of Garg et al 17 (Frequent Hemodialysis Network trials) and Jardine et al 81 (ACTIVE dialysis trial) were excluded because they focused on frequent HD that was not exclusively performed at home.…”

Section: Resultsmentioning

confidence: 99%

Health-Related Quality of Life in Home Dialysis Patients Compared to In-Center Hemodialysis Patients: A Systematic Review and Meta-analysis

et al. 2020

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Rationale & Objective Dialysis patients judge health-related quality of life (HRQoL) as an essential outcome. Remarkably, little is known about HRQoL differences between home dialysis and in-center hemodialysis (HD) patients worldwide. Study Design Systematic review and meta-analysis. Setting & Study Populations Search strategies were performed on the Cochrane Library, Pubmed, and EMBASE databases between 2007 and 2019. Home dialysis was defined as both peritoneal dialysis and home HD. Selection Criteria for Studies Randomized controlled trials and observational studies that compared HRQoL in home dialysis patients versus in-center HD patients. Data Extraction The data extracted by 2 authors included HRQoL scores of different questionnaires, dialysis modality, and subcontinent. Analytical Approach Data were pooled using a random-effects model and results were expressed as standardized mean difference (SMD) with 95% CIs. Heterogeneity was explored using subgroup analyses. Results Forty-six articles reporting on 41 study populations were identified. Most studies were cross-sectional in design (90%), conducted on peritoneal dialysis patients (95%), and used the 12-item or 36-item Short-Form Health Survey questionnaires (83%). More than half the studies showed moderate or high risk of bias. Pooled analysis of 4,158 home dialysis patients and 7,854 in-center HD patients showed marginally better physical HRQoL scores in home dialysis patients compared with in-center HD patients (SMD, 0.14; 95% CI, 0.04 to 0.24), although heterogeneity was high ( I 2 >80%). In a subgroup analysis, Western European home dialysis patients had higher physical HRQoL scores (SMD, 0.39; 95% CI, 0.17 to 0.61), while home dialysis patients from Latin America had lower physical scores (SMD, −0.20; 95% CI, −0.28 to −0.12). Mental HRQoL showed no difference in all analyses. Limitations No randomized controlled trials were found and high heterogeneity among studies existed. Conclusions Although pooled data showed marginally better physical HRQoL for home dialysis patients, the quality of design of the included studies was poor. Large prospective studies with adequate adjustments for confounders are necessary to establish whether home dialysis results in better HRQoL. Trial Registration PROSPERO 95985.

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Section: Resultsmentioning

confidence: 99%

Health-Related Quality of Life in Home Dialysis Patients Compared to In-Center Hemodialysis Patients: A Systematic Review and Meta-analysis

et al. 2020

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“…The transplant is viewed as a ‘light at the end of the tunnel’ (Moran et al ; Yngman‐Uhlin et al ) and finding ‘freedom’ despite ongoing uncertainty (Lonargáin et al ). Even the act of being placed on the transplant waiting list has been linked to better HRQOL and less depression (Santos ; Osthus et al ), possibly reflecting the transplant selection criteria (Transplantation Society of Australia and New Zealand (TSANZ) ) which picks out healthier candidates with less physical co‐morbidities. While they wait people describe their life as being ‘on hold’ (Moran et al ) and ‘in standby’ (Yngman‐Uhlin et al ).…”

Section: Literature Reviewmentioning

confidence: 99%

The experience of waiting for a kidney transplant: A qualitative study

Burns

Fernandez

Stephens

2017

Journal of Renal Care

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SUMMARY Background: In Australia over 1100 people are living on dialysis while waiting for a kidney transplant from a deceased donor. Worldwide there are an estimated 170,000 people who wait an average of three years before an organ becomes available. Objective: To provide an understanding of the lived experience of people waiting on dialysis for a kidney transplant from a deceased donor. Approach: A qualitative descriptive research design was used. Participants were recruited from a large metropolitan hospital. Two focus groups were conducted with six participants ranging in age from 29–63 years, with dialysis experience of 10–72 months. Data saturation was achieved and thematic analysis was used to interpret the data providing a descriptive account of the experience of waiting for a kidney transplant. Findings: Waiting for a kidney transplant takes place in the context of living on dialysis. Four main themes were identified: living on dialysis is physically and mentally demanding; living with uncertainty; altered relationship dynamics; and feelings towards the deceased donor. Conclusions: This study provides a descriptive summary of what it is like to live on dialysis while waiting for a kidney transplant from a deceased donor from the perspective of the person waiting. People are burdened by; uncertainty; the experience of the dialysis therapy; and the thought of the human cost of transplantation. These findings suggest that this cohort may benefit from strategies to relieve uncertainty such as effective communication from the treating team and peer support from the dialysis community.

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“…Actually, PCS and MCS scores in the previously transplanted patients in the two studies were quite similar, and the divergent conclusions might be explained by differences in the comparator groups. We have previously reported that dialysis patients on the waiting list for renal transplantation are doing better than those rejected for future transplantation [29]. The prospect of getting a retransplantation is high in Norway, the median time on the waiting list overall is 7 months [23], and this may have attenuated presumed differences between the two groups of dialysis patients in the present study.…”

Section: Discussionmentioning

confidence: 60%

Health related quality of life in patients in dialysis after renal graft loss and effect of gender

et al. 2014

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BackgroundAn increasing number of dialysis patients have returned to dialysis after renal graft loss, and the transition in disease state could likely be associated with reduced health related quality of life (HRQOL). Furthermore, gender differences in HRQOL have been observed in dialysis and kidney transplanted patients, but whether transition in disease state affects HRQOL differently in respect to gender is not known. The aims of this study were to compare HRQOL in dialysis patients with graft loss to transplant naïve dialysis patients, and to explore possible gender differences.MethodsIn a cross-sectional study, HRQOL was measured in 301 prevalent dialysis patients using the Kidney Disease and Quality of Life Short Form version 1.3. Adjusted comparisons were made between dialysis patients with previous graft loss and the transplant naïve patients. Multiple linear regression analyses were performed with HRQOL as outcome variables. Interaction analyses using product terms were performed between gender and graft loss. HRQOL was analysed separately in both genders.ResultsPatients with renal graft loss (n = 50) did not experience lower HRQOL than transplant naïve patients after multiple adjustments. Among patients with graft loss, women (n = 23) reported lower HRQOL than men (n = 27) in the items physical function (40 vs. 80, p = 0.006), and effect of kidney disease (49 vs. 67, p = 0.017). Women with graft loss reported impaired kidney-specific HRQOL compared to transplant naïve women (n = 79) in the items effect of kidney disease (50 vs. 72, p = 0.002) and cognitive function (80 vs. 93, p = 0.006), and this observation persisted after multiple adjustments. Such differences were not apparent in the male counterparts.ConclusionsPatients who resumed dialysis after renal graft loss did not have lower HRQOL than dialysis patients not previously transplanted. However, losing graft function was associated with reduced HRQOL in females, and important interactions were identified between graft loss and gender. This needs to be further explored in prospective studies.

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Renal Transplant Acceptance Status, Health‐related Quality of Life and Depression in Dialysis Patients

Cited by 6 publications

References 42 publications

Health-Related Quality of Life in Home Dialysis Patients Compared to In-Center Hemodialysis Patients: A Systematic Review and Meta-analysis

Health-Related Quality of Life in Home Dialysis Patients Compared to In-Center Hemodialysis Patients: A Systematic Review and Meta-analysis

The experience of waiting for a kidney transplant: A qualitative study

Health related quality of life in patients in dialysis after renal graft loss and effect of gender

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