Predictors of perceived health status in patients after kidney transplantation.

BACKGROUND: Patients after kidney transplantation have decreased mortality, morbidity and better quality of life compared to people on dialysis. Major efforts are being directed towards research into graft and patient survival. Research into quality of life is less intensive. The aim of this study was to explore the predictors of perceived health status (PHS) in kidney transplant recipients.
METHODS: Out of 218 patients after kidney transplantation 138 participated in the study. Linear regression analysis was performed to predict PHS, measured with the SF-36 questionnaire, in three age categories (<40, 40-59, >or=60 years). Independent variables included social support (measured with the Social Support List Discrepancies questionnaire), sociodemographic and medical variables, side effects and compliance.
RESULTS: Predictors of better PHS in patients<40 years were better social support (P<or=0.001), lower creatinine (P<or=0.001) and lower stress from adverse effects (P<or=0.001). In the group of patients aged 40-59 years higher education (P<or=0.05), increased housekeeping activities (P<or=0.01) and lower stress from adverse effects (P<or=0.001) predicted better PHS. In the last age group predictors of better PHS were lower rate of dialysis (P<or=0.05) and posttransplant hospitalizations (P<or=0.01), absence of diabetes mellitus (P<or=0.01) and lower stress from adverse effects (P<or=0.05).
CONCLUSIONS: Major differences exist in PHS among kidney transplant recipients depending on their age. Side effects of therapy are the most important predictor of PHS for all age groups. PHS of young patients mostly depends on their renal function and their social support. Education and working activities are most important for middle-aged people whereas in older patients PHS is mostly affected by comorbidity.