Quality of Life in Kidney Transplantation
Kidney transplantation is the best modality of renal replacement for patients on hemodialysis for end-stage renal disease. 1-year graft and patient survival, thanks to the improvement in surgical techniques and immunosuppression management, is now up to 9
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Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2228
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Definition and HRQOL Assessment Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2230
3 3.1 3.2 3.3 3.4 3.5 3.6
Kidney Transplant Recipients: the Uniqueness of HRQOL . . . . . . . . . . . . . . . . . . . . . . 2230 Comparison of Post-Transplant HRQOL with the Pre-Transplant Conditions . . . . 2230 Comparison of HRQOL Between Different Types of Transplant . . . . . . . . . . . . . . . . . . 2231 Long-Term Transplantation and HRQOL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2232 Co Morbid Illnesses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2232 Socio-Demographic Correlations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2233 Immunosuppression-Related Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2234
4 Future Directions in HRQOL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2235 4.1 How to Improve the HRQOL in Kidney Transplant Recipients? . . . . . . . . . . . . . . . . . . 2236 Summary Points . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2237
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Springer Science+Business Media LLC 2010 (USA)
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Quality of Life in Kidney Transplantation
Abstract: Kidney transplantation is the best modality of renal replacement for patients on hemodialysis for end-stage renal disease. 1-year graft and patient survival, thanks to the improvement in surgical techniques and immunosuppression management, is now up to 90%. In this view, the attention of the clinics has shifted toward health-related quality of life (HRQOL) as the best indicator of medical care in kidney transplant recipients. A number of tools have been suggested for this purpose, but the 36-item short-form has been widely adopted as indicator of quality of life in this population of transplanted patients. In general, HRQOL assessment improves after transplantation in functional and physical domains when compared with dialysis, but kidney recipients scored worse than the healthy general population. HRQOL may be negatively influenced by several factors, including co-morbidity conditions, kidney function, employment status and immunosuppressive medications side effects. Perceived physical appearance, issues related to sexuality, stress anxiety and even guilty may complicate the emotional and psychological status of kidney transplant recipients. Many events, such as non-adherence to treatment, especially in pediatric and adolescent population, may be significantly influenced by HRQOL. In this view, there is a clear need to adopt standardized methodologies to improve our abil
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