Predictors of employment after successful kidney transplantation - a population-based study.

INTRODUCTION: Kidney transplantation is currently the treatment of choice for end-stage renal disease. As the successful transplantation improves the physical and mental quality of life, it is expected that the transplant recipient should play a productive role in the society. The present study evaluates the occurrence and predictors of employment after kidney transplantation. METHODS: Population-based cross-sectional study in which 272 adult kidney recipients assisted in a Brazilian Southern state were evaluated. RESULTS: At the moment of the interview, 29% of the patients were employed. After analysis with logistic regression, the predictors of employment were male sex (OR 4.04; 95% CI 1.99-8.23), pre-transplant employment for non-diabetic (OR 4.35; 95% CI 3.79-4.99), diabetes for individuals who worked while on dialysis (OR 0.06; 95% CI 0.008-0.5), high educational level for individuals with mental quality of life scores above the 25th percentile (OR 3.06; 95% CI 2.98-3.14 for 50th percentile of mental quality of life). The Hosmer-Lemeshow test was of 3.33 (p = 0.91). CONCLUSION: The participation of the kidney transplant recipients with functioning graft into the work force in the Brazilian state of Rio Grande do Sul is low, being predicted mainly by sociodemographic factors. It was not detected any influence of patient perception of his/her physical conditions or other clinical variables, except for the presence of diabetes.

Tacrolimus and quality of life after kidney transplantation--a multicenter study.

Kidney transplantation is currently the treatment of choice for end-stage renal disease. Although new immunosuppressive drugs have been introduced into clinical practice, the effect of such medication on quality of life (QoL) in transplant recipients is still unclear. The present study analyzes the impact of tacrolimus-based immunosuppression on QoL in a representative sample of adult kidney transplant recipients from Rio Grande do Sul, a Brazilian southern state. This was a cross-sectional multicenter study which used the SF-36 Health Survey for measuring QoL. The effect of tacrolimus on QoL was adjusted for possible confounders using multiple linear regression. A total of 272 patients (from 11 different centers) were evaluated, 48 of them were treated with tacrolimus. Transplant patients in use of tacrolimus presented significant higher scores in the physical component summary of SF-36 than non-users (49.1+/-8.3 vs. 46.1+/-8.7; p=0.03), and such difference was noted in the physical functioning and general health subscales (81.5+/-17.1 and 74.7+/-21.8; 74.6+/-22.3 and 67.1+/-22.3 for users and non-users of tacrolimus, respectively, p<0.05). The effect of tacrolimus remained significant after adjustment for age, gender, skin color and time since transplantation (coeff.: 2.83; 95% CI: 0.05-5.6, p=0.045). The association between tacrolimus-based immunosuppression and better perception of physical functioning and general health for renal transplant patients represents a significant finding as it may influence therapeutical decisions and contribute to maximize kidney transplantation benefits.