Sleep disorders, depressive symptoms and health-related quality of life-a cross-sectional comparison between kidney transplant recipients and waitlisted patients on maintenance dialysis

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Abstract

Background: Kidney transplantation is believed to improve health-related quality of life (HRQoL) of patients requiring renal replacement therapy (RRT). Recent studies suggested that the observed difference in HRQoL between kidney transplant recipients (Tx) vs patients treated with dialysis may reflect differences in patient characteristics. We tested if Tx patients have better HRQoL compared to waitlisted (WL) patients treated with dialysis after extensive adjustment for covariables.Methods. Eight hundred and eighty-eight prevalent Tx patients followed at a single outpatient transplant clinic and 187 WL patients treated with maintenance dialysis in nine dialysis centres were enrolled in this observational cross-sectional study. Data about socio-demographic and clinical parameters, self-reported depressive symptoms and the most frequent sleep disorders assessed by self-reported questionnaires were collected at enrolment. HRQoL was assessed by the Kidney Disease Quality of Life Questionnaire.Results. Patient characteristics were similar in the Tx vs WL groups: the proportion of males (58 vs 60%), mean ± SD age (49 ± 13 vs 49 ± 12) and proportion of diabetics (17 vs 18%), respectively, were all similar. Tx patients had significantly better HRQoL scores compared to the WL group both in generic (Physical function, General health perceptions, Energy/fatigue, Emotional well-being) and in kidney disease-specific domains (Symptoms/problems, Effect- and Burden of kidney disease and Sleep). In multivariate regression models adjusting for clinical and socio-demographic characteristics, sleep disorders and depressive symptoms, the modality of RRT (WL vs Tx) remained independently associated with three (General health perceptions, Effect- and Burden of kidney disease) out of the eight HRQoL dimensions analysed.Conclusions. Kidney Tx recipients have significantly better HRQoL compared to WL dialysis patients in some, but not all, dimensions of quality of life after accounting for differences in patient characteristics. Utilizing multidimensional disease-specific questionnaires will allow better understanding of treatment, disease and patient-related factors potentially affecting quality of life in patients with chronic medical conditions.

Original languageEnglish
Pages (from-to)1058-1065
Number of pages8
JournalNephrology Dialysis Transplantation
Volume26
Issue number3
DOIs
Publication statusPublished - Mar 2011

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Dialysis
Maintenance
Quality of Life
Depression
Kidney
Kidney Diseases
Renal Replacement Therapy
Sleep Wake Disorders
Transplant Recipients
Demography
Health
Ambulatory Care Facilities
Kidney Transplantation
Fatigue
Sleep
Cross-Sectional Studies
Transplants

Keywords

  • depression
  • dialysis
  • health-related quality of life
  • kidney transplantation
  • sleep disorders

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

@article{6798af922f62442b8b08584355c536ab,
title = "Sleep disorders, depressive symptoms and health-related quality of life-a cross-sectional comparison between kidney transplant recipients and waitlisted patients on maintenance dialysis",
abstract = "Background: Kidney transplantation is believed to improve health-related quality of life (HRQoL) of patients requiring renal replacement therapy (RRT). Recent studies suggested that the observed difference in HRQoL between kidney transplant recipients (Tx) vs patients treated with dialysis may reflect differences in patient characteristics. We tested if Tx patients have better HRQoL compared to waitlisted (WL) patients treated with dialysis after extensive adjustment for covariables.Methods. Eight hundred and eighty-eight prevalent Tx patients followed at a single outpatient transplant clinic and 187 WL patients treated with maintenance dialysis in nine dialysis centres were enrolled in this observational cross-sectional study. Data about socio-demographic and clinical parameters, self-reported depressive symptoms and the most frequent sleep disorders assessed by self-reported questionnaires were collected at enrolment. HRQoL was assessed by the Kidney Disease Quality of Life Questionnaire.Results. Patient characteristics were similar in the Tx vs WL groups: the proportion of males (58 vs 60{\%}), mean ± SD age (49 ± 13 vs 49 ± 12) and proportion of diabetics (17 vs 18{\%}), respectively, were all similar. Tx patients had significantly better HRQoL scores compared to the WL group both in generic (Physical function, General health perceptions, Energy/fatigue, Emotional well-being) and in kidney disease-specific domains (Symptoms/problems, Effect- and Burden of kidney disease and Sleep). In multivariate regression models adjusting for clinical and socio-demographic characteristics, sleep disorders and depressive symptoms, the modality of RRT (WL vs Tx) remained independently associated with three (General health perceptions, Effect- and Burden of kidney disease) out of the eight HRQoL dimensions analysed.Conclusions. Kidney Tx recipients have significantly better HRQoL compared to WL dialysis patients in some, but not all, dimensions of quality of life after accounting for differences in patient characteristics. Utilizing multidimensional disease-specific questionnaires will allow better understanding of treatment, disease and patient-related factors potentially affecting quality of life in patients with chronic medical conditions.",
keywords = "depression, dialysis, health-related quality of life, kidney transplantation, sleep disorders",
author = "A. Kov{\'a}cs and M. Moln{\'a}r and L. Szeifert and C. Ambrus and Marta Molnar-Varga and A. Szentkir{\'a}lyi and I. Mucsi and M. Nov{\'a}k",
year = "2011",
month = "3",
doi = "10.1093/ndt/gfq476",
language = "English",
volume = "26",
pages = "1058--1065",
journal = "Nephrology Dialysis Transplantation",
issn = "0931-0509",
publisher = "Oxford University Press",
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T1 - Sleep disorders, depressive symptoms and health-related quality of life-a cross-sectional comparison between kidney transplant recipients and waitlisted patients on maintenance dialysis

AU - Kovács, A.

AU - Molnár, M.

AU - Szeifert, L.

AU - Ambrus, C.

AU - Molnar-Varga, Marta

AU - Szentkirályi, A.

AU - Mucsi, I.

AU - Novák, M.

PY - 2011/3

Y1 - 2011/3

N2 - Background: Kidney transplantation is believed to improve health-related quality of life (HRQoL) of patients requiring renal replacement therapy (RRT). Recent studies suggested that the observed difference in HRQoL between kidney transplant recipients (Tx) vs patients treated with dialysis may reflect differences in patient characteristics. We tested if Tx patients have better HRQoL compared to waitlisted (WL) patients treated with dialysis after extensive adjustment for covariables.Methods. Eight hundred and eighty-eight prevalent Tx patients followed at a single outpatient transplant clinic and 187 WL patients treated with maintenance dialysis in nine dialysis centres were enrolled in this observational cross-sectional study. Data about socio-demographic and clinical parameters, self-reported depressive symptoms and the most frequent sleep disorders assessed by self-reported questionnaires were collected at enrolment. HRQoL was assessed by the Kidney Disease Quality of Life Questionnaire.Results. Patient characteristics were similar in the Tx vs WL groups: the proportion of males (58 vs 60%), mean ± SD age (49 ± 13 vs 49 ± 12) and proportion of diabetics (17 vs 18%), respectively, were all similar. Tx patients had significantly better HRQoL scores compared to the WL group both in generic (Physical function, General health perceptions, Energy/fatigue, Emotional well-being) and in kidney disease-specific domains (Symptoms/problems, Effect- and Burden of kidney disease and Sleep). In multivariate regression models adjusting for clinical and socio-demographic characteristics, sleep disorders and depressive symptoms, the modality of RRT (WL vs Tx) remained independently associated with three (General health perceptions, Effect- and Burden of kidney disease) out of the eight HRQoL dimensions analysed.Conclusions. Kidney Tx recipients have significantly better HRQoL compared to WL dialysis patients in some, but not all, dimensions of quality of life after accounting for differences in patient characteristics. Utilizing multidimensional disease-specific questionnaires will allow better understanding of treatment, disease and patient-related factors potentially affecting quality of life in patients with chronic medical conditions.

AB - Background: Kidney transplantation is believed to improve health-related quality of life (HRQoL) of patients requiring renal replacement therapy (RRT). Recent studies suggested that the observed difference in HRQoL between kidney transplant recipients (Tx) vs patients treated with dialysis may reflect differences in patient characteristics. We tested if Tx patients have better HRQoL compared to waitlisted (WL) patients treated with dialysis after extensive adjustment for covariables.Methods. Eight hundred and eighty-eight prevalent Tx patients followed at a single outpatient transplant clinic and 187 WL patients treated with maintenance dialysis in nine dialysis centres were enrolled in this observational cross-sectional study. Data about socio-demographic and clinical parameters, self-reported depressive symptoms and the most frequent sleep disorders assessed by self-reported questionnaires were collected at enrolment. HRQoL was assessed by the Kidney Disease Quality of Life Questionnaire.Results. Patient characteristics were similar in the Tx vs WL groups: the proportion of males (58 vs 60%), mean ± SD age (49 ± 13 vs 49 ± 12) and proportion of diabetics (17 vs 18%), respectively, were all similar. Tx patients had significantly better HRQoL scores compared to the WL group both in generic (Physical function, General health perceptions, Energy/fatigue, Emotional well-being) and in kidney disease-specific domains (Symptoms/problems, Effect- and Burden of kidney disease and Sleep). In multivariate regression models adjusting for clinical and socio-demographic characteristics, sleep disorders and depressive symptoms, the modality of RRT (WL vs Tx) remained independently associated with three (General health perceptions, Effect- and Burden of kidney disease) out of the eight HRQoL dimensions analysed.Conclusions. Kidney Tx recipients have significantly better HRQoL compared to WL dialysis patients in some, but not all, dimensions of quality of life after accounting for differences in patient characteristics. Utilizing multidimensional disease-specific questionnaires will allow better understanding of treatment, disease and patient-related factors potentially affecting quality of life in patients with chronic medical conditions.

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KW - dialysis

KW - health-related quality of life

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KW - sleep disorders

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