Gastrointestinal symptoms impair quality of life in Italian renal transplant recipients but are under-recognized by physicians.
We assessed patient- and physician-reported prevalence of gastrointestinal symptoms and their impact on quality of life (QOL) in Italian renal transplant recipients with stable graft function. Patients ≥18years with a renal allograft functioning for ≥6months and stable serum creatinine levels of <2.5mg/dl were enrolled. Physicians and patients completed an Italian translation of the Gastrointestinal Symptom Rating Scale (GSRS) and Gastrointestinal Quality of Life Index (GIQLI) questionnaires. The average time since transplantation (n=1130) was 5.9years. Forty-two immunosuppressant drug regimens were reported. The top three regimens (cyclosporine/mycophenolate mofetil/steroids; tacrolimus/mycophenolate mofetil/steroids; cyclosporine/steroids) accounted for approximately 40% of patients. In the physician interview, 39.2% of patients had ≥1 gastrointestinal symptom vs. 88.3% of patients in the self-administered questionnaire. The prevalence of GSRS symptoms was similar for each of the most frequently prescribed immunosuppressant drug regimens. GIQLI total score was significantly poorer in patients with versus those without gastrointestinal symptoms (121.8±17.6 vs. 138.4±3.7; P<0.0001), and there was a strong inverse correlation between GIQLI and patient-reported GSRS scores (Pearson's correlation coefficient -0.816; P<0.0001). Gastrointestinal symptoms are frequent in renal transplant patients, are under-evaluated by physicians and may adversely impact on patient QOL.
Nephrology and Dialysis Unit, Scientific Institute Humanitas, Rozzano, Milano, Italy. claudio.ponticelli@fastwebnet.it
Claudio
C
Ponticelli
Delia
D
Colombo
Monica
M
Novara
Guido
G
Basilisco
D000328:Adult; D016572:Cyclosporine / Q000009:adverse effects; D003951:Diagnostic Errors; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced*; D041981:Gastrointestinal Tract / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007558:Italy; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives; D011446:Prospective Studies; D011788:Quality of Life; D013256:Steroids / Q000009:adverse effects; D016559:Tacrolimus / Q000009:adverse effects; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D013256:Steroids; D016572:Cyclosporine; D009173:Mycophenolic Acid; D016559:Tacrolimus