Line Auneau-Enjalbert1,2, Jean-Benoit Hardouin1,2, Myriam Blanchin1, Magali Giral3, Emmanuel Morelon4, Elisabeth Cassuto5, Aurélie Meurette3, Véronique Sébille6,7. 1. UMR INSERM 1246, SPHERE "MethodS in Patient-centered outcomes and HEalth ResEarch", Université de Nantes, Université de Tours, 22 Boulevard Benoni Goullin, Nantes, France. 2. Plateforme de Méthodologie et Biostatistique, CHU Nantes, Nantes, France. 3. Centre de Recherche en Transplantation et Immunologie INSERM, UMR1064, Université de Nantes, Centre Hospitalier Universitaire de Nantes, RTRS «Centaure», Nantes, France. 4. Néphrologie, Transplantation et Immunologie Clinique, Hôpital Edouard Herriot, Lyon, France. 5. Service de Néphrologie, Hôpital Pasteur, Nice, France. 6. UMR INSERM 1246, SPHERE "MethodS in Patient-centered outcomes and HEalth ResEarch", Université de Nantes, Université de Tours, 22 Boulevard Benoni Goullin, Nantes, France. veronique.sebille@univ-nantes.fr. 7. Plateforme de Méthodologie et Biostatistique, CHU Nantes, Nantes, France. veronique.sebille@univ-nantes.fr.
Abstract
PURPOSE: The waiting list period for kidney transplantation can be lengthy and associated with a deteriorated health-related quality of life (HRQoL). It might also be experienced differently depending on the experience of renal replacement therapy (preemptive or dialyzed patients), and the type of dialysis. The main objective of this study is to measure and compare HRQoL changes in preemptive, hemodialysis (HD), and peritoneal dialysis (PD) patients during the waiting list period for kidney transplantation. METHODS: A sample of adult patients on kidney transplant waiting list from three French University Hospital centers was recruited. HRQoL was measured using the SF-36 and a specific questionnaire (ReTransQol), which were collected every 6 months before transplantation in preemptive, HD, and PD patients. Mixed-effects models taking into account time and possible confounding factors were used to compare HRQoL changes between the three groups. RESULTS: Preemptive (n = 230), HD (n = 177), and PD patients (n = 39) were enrolled. The renal replacement therapy modalities, time (time on waiting list and age at registration), and gender were associated with HRQoL changes. The HD and PD patients had a significantly lower perceived HRQoL on Role Physical, Social Functioning, and Role Emotional dimensions than the preemptive patients, with lower scores for PD compared to HD patients. The HRQoL scores of all patients were lower compared to the French general population for all dimensions. CONCLUSIONS: A better understanding of pre-transplantation patients' experience can help improving patient care with adapted educational programs and psychological support depending on the type of renal replacement therapy.
PURPOSE: The waiting list period for kidney transplantation can be lengthy and associated with a deteriorated health-related quality of life (HRQoL). It might also be experienced differently depending on the experience of renal replacement therapy (preemptive or dialyzed patients), and the type of dialysis. The main objective of this study is to measure and compare HRQoL changes in preemptive, hemodialysis (HD), and peritoneal dialysis (PD) patients during the waiting list period for kidney transplantation. METHODS: A sample of adult patients on kidney transplant waiting list from three French University Hospital centers was recruited. HRQoL was measured using the SF-36 and a specific questionnaire (ReTransQol), which were collected every 6 months before transplantation in preemptive, HD, and PDpatients. Mixed-effects models taking into account time and possible confounding factors were used to compare HRQoL changes between the three groups. RESULTS: Preemptive (n = 230), HD (n = 177), and PDpatients (n = 39) were enrolled. The renal replacement therapy modalities, time (time on waiting list and age at registration), and gender were associated with HRQoL changes. The HD and PDpatients had a significantly lower perceived HRQoL on Role Physical, Social Functioning, and Role Emotional dimensions than the preemptive patients, with lower scores for PD compared to HDpatients. The HRQoL scores of all patients were lower compared to the French general population for all dimensions. CONCLUSIONS: A better understanding of pre-transplantation patients' experience can help improving patient care with adapted educational programs and psychological support depending on the type of renal replacement therapy.
Entities:
Keywords:
Dialysis; Kidney transplantation; Preemptive; Quality of life; Waiting list
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