title: Self-rated health predicts mortality and graft loss after kidney transplantation: a 10-year follow-up study.
abstract: BACKGROUND
  This study explored whether self-rated health (SRH) shortly after kidney transplantation (KT) predicts mortality and graft loss at up to 10 years' follow-up.
  
  
  METHODS
  A total of 276 patients shortly after successful KT were interviewed. SRH was measured using the first item of the SF-36 questionnaire and divided into three tertiles: poor, average and excellent health. Clinical data were retrieved from medical records. Cox regression was used to identify whether different levels of SRH predicted mortality and graft loss in transplant recipients. The observation period was up to 10 years.
  
  
  RESULTS
  Poor SRH (HR 11.1, p < 0.001), average SRH (HR 4.21, p < 0.05), estimated glomerular filtration rate (HR 0.26, p < 0.05) and age (HR 1.04, p < 0.05) were significantly associated with mortality. Similarly, poor SRH (HR 6.4, p < 0.001), average SRH (HR 3.6, p < 0.05), new-onset diabetes mellitus after KT (HR 3.3, p < 0.05) and chronic renal allograft dysfunction (HR 3.7, p < 0.00) were significantly associated with graft loss.
  
  
  CONCLUSIONS
  Poor SRH shortly after transplantation indicates an increased risk of mortality and graft loss at up to 10 years' follow-up. SRH could be an inexpensive and reliable indicator for starting diagnostic and/or treatment strategies. The usefulness of SRH compared to other global clinical measures predicting mortality and graft loss should also be studied.
authors.affiliation: Nephrology and Dialysis Centre Fresenius Medical Care, Kosice, Slovakia. mamajern@gmail.com
authors.forename: Maria
authors.initials: M
authors.lastname: Majernikova
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Rosenberger
authors.forename: Lucia
authors.initials: L
authors.lastname: Prihodova
authors.forename: Iveta
authors.initials: I
authors.lastname: Nagyova
authors.forename: Robert
authors.initials: R
authors.lastname: Roland
authors.forename: Johan W
authors.initials: JW
authors.lastname: Groothoff
authors.forename: Jitse P
authors.initials: JP
authors.lastname: van Dijk
mesh_terms: D059026:Diagnostic Self Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors