title: Impaired renal function is associated with worse self-reported outcomes after kidney transplantation.
abstract: OBJECTIVE
  We sought to determine the association between health-related quality of life (HRQOL) and graft function in renal transplant recipients.
  
  
  METHODS
  We enrolled 577 kidney transplant recipients aged 18-74 years (response rate 87%). Recipients with multiple or multi-organ transplantation, creatine kinase >200 U/L, acute renal failure or cellular rejection (n = 64), and without creatinine assessments in 3 months pre-enrollment (n = 127) were excluded. The questionnaire included Euro QOL 5 Dimensions (EQ-5D), Health Utility Index III (HUI-III), Kidney Disease Quality of Life-36 (KDQOL36) which include a generic section (RAND SF-12). Data on medical conditions, therapy regimens, and biochemistry results were extracted from clinical charts. We used general linear models adjusted for demographic, socioeconomic, and clinical characteristics to assess the association between HRQOL and severity of chronic kidney disease (CKD).
  
  
  RESULTS
  Patients with more advanced CKD were more likely to be African-American, covered by public insurance, more likely to have shorter time after transplantation, higher phosphorus and lower hemoglobin, serum albumin, and calcium levels. All HRQOL scales were inversely associated with CKD severity. All associations were robust to adjustment for possible confounders.
  
  
  CONCLUSIONS
  Several health-related quality of life dimensions may be affected by poor renal function after transplantation.
authors.affiliation: Dipartimento di Medicina del Lavoro, Clinica del Lavoro L Devoto-Divisione di Ergonomia e Psicologia del Lavoro, Università degli Studi di Milano, Via San Barnaba 8, Milan, Italy. lneri@slu.edu
authors.forename: Luca
authors.initials: L
authors.lastname: Neri
authors.forename: Jonathan
authors.initials: J
authors.lastname: Dukes
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Brennan
authors.forename: Paulo R
authors.initials: PR
authors.lastname: Salvalaggio
authors.forename: Susmitha
authors.initials: S
authors.lastname: Seelam
authors.forename: Srividya
authors.initials: S
authors.lastname: Desiraju
authors.forename: Mark
authors.initials: M
authors.lastname: Schnitzler
mesh_terms: D058186:Acute Kidney Injury / Q000503:physiopathology / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006789:Host vs Graft Reaction; D006801:Humans; D007676:Kidney Failure, Chronic / Q000145:classification / Q000503:physiopathology / Q000523:psychology*; D016030:Kidney Transplantation; D016015:Logistic Models; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011788:Quality of Life; D057566:Self Report; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D016896:Treatment Outcome; D055815:Young Adult