title: Health-related quality of life in kidney transplant patients with diabetes.
abstract: OBJECTIVE
  We sought to assess the disutility associated with diabetes in the kidney transplant population.
  
  
  METHODS
  We enrolled 233 kidney transplant recipients age 18-74 from a Midwestern hospital outpatient department. Recipients with multiple or multi-organ transplants, those with laboratory evidence that suggests acute cellular damage (creatinine-kinase > 200 U/L), or a diagnosis of acute renal failure or acute rejection were excluded from the analysis (n = 33). Participants health-related quality of life (HRQOL) were evaluated using the Euro-QoL-5 Dimension (EQ-5D), Health Utility Index Mark III (HUI-III), and the Short Form-6D (SF-6D), which was calculated from the generic section (SF-12) of the Kidney Disease Quality of Life 36 (KDQOL-36). We estimated health utilities associated with diabetes using general linear modeling after adjusting for demographic, socioeconomic, and clinical characteristics.
  
  
  RESULTS
  The adjusted health disutilities associated with diabetes were clinically and statistically significant: EQ-5D (Δ = 0.05; p < 0.01), HUI-III (Δ = 0.09; p < 0.01), and SF-6D (Δ = 0.04, p < 0.01). There was no difference between diabetic patients with good glycemic control (mean serum glucose <126 mg/dL in the three months prior to enrollment) and patients with poor glycemic control.
  
  
  CONCLUSIONS
  Among kidney transplant patients between the ages of 18-74, non-diabetics have significantly higher HRQOL scores on the EQ-5D, HUI-III, and SF-6D compared with patients with diabetes.
authors.affiliation: Center for Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO, USA; Division of Infectious Diseases, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Dukes
authors.forename: Susmitha
authors.initials: S
authors.lastname: Seelam
authors.forename: Krista L
authors.initials: KL
authors.lastname: Lentine
authors.forename: Mark A
authors.initials: MA
authors.lastname: Schnitzler
authors.forename: Luca
authors.initials: L
authors.lastname: Neri
mesh_terms: D058186:Acute Kidney Injury / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D048909:Diabetes Complications / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000209:etiology; D006304:Health Status; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D055815:Young Adult
keywords: diabetes; generic health indexes; health-related quality of life; kidney transplant