Health-related quality of life outcomes after kidney transplantation
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Open Access
Review
Health-related quality of life outcomes after kidney transplantation Wolfgang Fiebiger1, Christa Mitterbauer2 and Rainer Oberbauer*2 Address: 1Departments of Internal Medicine I and III, Division of Oncology, University of Vienna, Austria and 2Department of Nephrology, University of Vienna, Austria Email: Wolfgang Fiebiger - [email protected]; Christa Mitterbauer - [email protected]; Rainer Oberbauer* - [email protected] * Corresponding author
Published: 08 January 2004 Health and Quality of Life Outcomes 2004, 2:2
Received: 11 December 2003 Accepted: 08 January 2004
This article is available from: http://www.hqlo.com/content/2/1/2 © 2004 Fiebiger et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
Abstract With the improvements in short and long term graft and patient survival after renal transplantation over the last two decades Health-Related Quality of Life (HRQL) is becoming an important additional outcome parameter. Global and disease specific instruments are available to evaluate objective and subjective QOL. Among the most popular global tools is the SF-36, examples of disease specific instruments are the Kidney Transplant Questionnaire (KTQ), the Kidney Disease Questionnaire (KDQ) and the Kidney Disease-Quality of Life (KDQOL). It is generally accepted that HRQL improves dramatically after successful renal transplantation compared to patients maintained on dialysis treatment but listed for a transplant. It is less clear however which immunosuppressive regimen confers the best QOL. Only few studies compared the different regimens in terms of QOL outcomes. Although limited in number, these studies seem to favour non-cyclosporine based protocols. The main differences that could be observed between patients on cyclosporine versus tacrolimus or sirolimus therapy concern the domains of appearance and fatigue. This may be explained by two common adverse effects occurring under cyclosporine therapy, gingival hyperplasia and hair growth. Another more frequently occurring side effect under calcineurin inhibitor therapy is tremor, which may favour CNI free protocols. This hypothesis, however, has not been formally evaluated in a randomised trial using HRQL measurements. In summary HRQL is becoming more of an issue after renal transplantation. Whether a specific immunosuppressive protocol is superior to others in terms of HRQL remains to be determined.
Introduction Health-related quality of life (HRQL) contains multiple aspects of health related issues from the patients' perspective including physical, psychological, and social functioning and overall well-being [1-3]. Numerous clinical trials have established the importance of HRQL in various diseases, and it is increasingly popular to evaluate diseasespecific and generic HRQL in clinical trials as a measure of pat
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