Lieke Wirken1,2, Henriët van Middendorp1,2, Christina W Hooghof3, Jan-Stephan F Sanders4, Ruth E Dam5, Karlijn A M I van der Pant6, Judith M Wierdsma7, Hiske Wellink8, Elly M van Duijnhoven9, Andries J Hoitsma3, Luuk B Hilbrands3, Andrea W M Evers1,2,10. 1. Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands. 2. Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands. 3. Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands. 4. Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. 5. Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands. 6. Division of Nephrology, Department of Internal Medicine, Renal Transplant Unit, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 7. Department of Nephrology, University Medical Centre Utrecht, Utrecht, The Netherlands. 8. Department of Nephrology, VU Medical Center, Amsterdam, The Netherlands. 9. Division of Nephrology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands. 10. Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
Abstract
BACKGROUND: Previous studies have indicated decreased health-related quality of life (HRQoL) shortly after kidney donation, returning to baseline in the longer term. However, a subgroup of donors experiences persistent HRQoL problems. To identify which HRQoL aspects are impacted most by the donation and to identify at-risk donors, more specific insight into psychosocial donation consequences is needed. METHODS: The current study examined the HRQoL course, donor-perceived consequences of donation for donors, recipients and donor-recipient relationships, and regret up to 12 months post-donation in donors from seven Dutch transplantation centres. Kidney donor candidates (n = 588) completed self-report questionnaires early in the screening procedure, of which 361 (61%) donated their kidney. RESULTS: Data for 230 donors (64%) with complete assessments before donation and 6 and 12 months post-donation were analysed. Results indicated that donor physical HRQoL was comparable at all time points, except for an increase in fatigue that lasted up to 12 months post-donation. Mental HRQoL decreased at 6 months post-donation, but returned to baseline at 12 months. Donors reported large improvements in recipient's functioning and a smaller influence of the recipient's kidney disease or transplantation on the donor's life over time. A subgroup experienced negative donation consequences with 14% experiencing regret 12 months post-donation. Predictors of regret were more negative health perceptions and worse social functioning 6 months post-donation. The strongest baseline predictors of higher fatigue levels after donation were more pre-donation fatigue, worse general physical functioning and a younger age. CONCLUSIONS: Future research should examine predictors of HRQoL after donation to improve screening and to provide potential interventions in at-risk donors.
BACKGROUND: Previous studies have indicated decreased health-related quality of life (HRQoL) shortly after kidney donation, returning to baseline in the longer term. However, a subgroup of donors experiences persistent HRQoL problems. To identify which HRQoL aspects are impacted most by the donation and to identify at-risk donors, more specific insight into psychosocial donation consequences is needed. METHODS: The current study examined the HRQoL course, donor-perceived consequences of donation for donors, recipients and donor-recipient relationships, and regret up to 12 months post-donation in donors from seven Dutch transplantation centres. Kidney donor candidates (n = 588) completed self-report questionnaires early in the screening procedure, of which 361 (61%) donated their kidney. RESULTS: Data for 230 donors (64%) with complete assessments before donation and 6 and 12 months post-donation were analysed. Results indicated that donor physical HRQoL was comparable at all time points, except for an increase in fatigue that lasted up to 12 months post-donation. Mental HRQoL decreased at 6 months post-donation, but returned to baseline at 12 months. Donors reported large improvements in recipient's functioning and a smaller influence of the recipient's kidney disease or transplantation on the donor's life over time. A subgroup experienced negative donation consequences with 14% experiencing regret 12 months post-donation. Predictors of regret were more negative health perceptions and worse social functioning 6 months post-donation. The strongest baseline predictors of higher fatigue levels after donation were more pre-donation fatigue, worse general physical functioning and a younger age. CONCLUSIONS: Future research should examine predictors of HRQoL after donation to improve screening and to provide potential interventions in at-risk donors.
Authors: Carlos Garcia-Ochoa; Liane S Feldman; Chris Nguan; Mauricio Monroy-Caudros; Jennifer B Arnold; Lianne Barnieh; Neil Boudville; Meaghan S Cuerden; Christine Dipchand; John S Gill; Martin Karpinski; Scott Klarenbach; Greg Knoll; Charmaine E Lok; Matthew Miller; G V Ramesh Prasad; Jessica M Sontrop; Leroy Storsley; Amit X Garg Journal: Can J Kidney Health Dis Date: 2021-08-11
Authors: Lieke Wirken; Henriët van Middendorp; Christina W Hooghof; Jan-Stephan Sanders; Ruth Dam; Karlijn A M I van der Pant; Judith Wierdsma; Hiske Wellink; Philip Ulrichts; Andries J Hoitsma; Luuk B Hilbrands; Andrea W Evers Journal: BMJ Open Date: 2022-03-02 Impact factor: 2.692