Assessment of health-related quality of life in renal transplant and hemodialysis patients using the SF-36 health survey

• Published in: Urology (Ridgewood, N.J.) Vol. 56; no. 2; pp. 201 - 206
• Main Authors: Fujisawa, Masato, Ichikawa, Yasuji, Yoshiya, Kunihiko, Isotani, Shuji, Higuchi, Akihiro, Nagano, Shunsuke, Arakawa, Soichi, Hamami, Gaku, Matsumoto, Osamu, Kamidono, Sadao
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-08-2000; Elsevier Science
• Subjects: Adult; Biological and medical sciences; Creatine - blood; Female; Graft Rejection - epidemiology; Health Status Indicators; Humans; Kidney Failure, Chronic - psychology; Kidney Failure, Chronic - surgery; Kidney Failure, Chronic - therapy; Kidney Transplantation - psychology; Kidney Transplantation - statistics & numerical data; Male; Medical sciences; Psychometrics; Quality of Life; Regression Analysis; Renal Dialysis - psychology; Renal Dialysis - statistics & numerical data; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Kidney disease; Human; Postoperative; Urinary system disease; Hemodialysis; Transplantation; Homotransplantation; Survival; Kidney; Quality of life; Extrarenal dialysis; Chronic; Treatment; Surgery; Renal failure; Evolution
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/S0090-4295(00)00623-3

Objectives. To determine whether the health-related quality of life (HQOL) for renal transplant patients improved using SF-36 survey scores and to examine which clinical measures after renal transplantation are connected to aspects of their HQOL.
Methods. A total of 117 renal transplant patients and 114 hemodialysis patients, including 49 awaiting transplantation and 65 not awaiting transplantation, were included in this study. The scale scores of the SF-36 survey concerning HQOL were compared between the two groups of patients. The relationships of the clinical episode and complications with the scale scores were examined.
Results. The renal transplant patients had significantly higher scores in the physical functioning, bodily pain, general health, and social functioning scales than did the hemodialysis patients. The role-physical functioning, bodily pain, and social functioning scales of the transplant patients were significantly higher than those of the hemodialysis patients not awaiting transplantation. In contrast, the scores, except for that of general health, of the transplant patients were not significantly different from those of the hemodialysis patients awaiting transplantation. Multiple regression analysis demonstrated that the scale scores of physical functioning, general health, and vitality were significantly dependent on the serum level of creatinine in the renal transplant patients (
P <0.05). The scores of physical functioning and general health of the patients with a creatinine level >2 mg/dL were significantly lower than those of the patients with 1 mg/dL < creatinine level ≤1.5 mg/dL or a creatinine level ≤1 mg/dL (
P <0.05). An episode of hospitalization was not related to the scale scores, but an instance of rejection had an effect on the scores of social functioning and role-emotional functioning.
Conclusions. The SF-36 health survey is a short but comprehensive scale for evaluating a patient’s HQOL. The renal transplant patients’ HQOL improved compared with that of the hemodialysis patients. The most important factor affecting HQOL was the serum creatinine level at the time of testing with the SF-36 survey.