Assessment of quality of life in a single-center transplantation population using the Kidney Transplant Questionnaire-25 questionnaire.

BACKGROUND: The Kidney Transplant Questionnaire (KTQ) is a quality-of-life instrument designed specifically for renal transplant recipients. AIM: The purpose of this work was to evaluate the validity and reliability of a Persian translation of the KTQ-25 questionnaire as a tool for use in Iran and also to compare the quality of life between dialysis and transplant patients. METHOD: We collected 143 subjects in a cross-sectional study. Their mean age was 40.3±13.3 years (range=15-72). All KDQ-25 scales met the criteria for internal consistency(Cronbach's alpha ranged from 0.8-0.95) and in construct validity, the correlation coefficient between 5 scales and the total scale was also acceptable (0.84-0.91). Furthermore, significant correlations were detected between the scales (P<.001). RESULTS: The mean total score was 2.8±1.4 (range=5.8-1.5). The best mean score observed in uncertainty and fear item was 3.1±1.6 (range=0.5-7), while the lowest was detected in the emotional item, 2.4±1.3 (range=0.17-6). Mean follow-up was 50.1 (range=1-264) months. The most common physical problem was aching, tired legs in 77 (55%) subjects.In comparison between dialysis and transplant patients using the standard Iranian version of Kidney Disease Quality of Life (KDQOL) questionnaire, the total and disease-specific scores for dialysis patients were significantly better than the total score in the KDQ-25 (55.8±14 vs 40.7±20.2, P=.000) and (49.7±15.8 vs 40.7±20.2, P=.000), respectively. CONCLUSION: Considering its validity and reliability, the Persian version of KTQ-25 questionnaire may be useful to assess the health-related quality of life among Iranian transplant recipients.

Anxiety and depression: a comparison between renal transplant recipients and hemodialysis patients.

BACKGROUND: Anxiety and depression are known causes of morbidity among patients with chronic illnesses. There is controversy whether hemodialysis or renal transplanted subjects have less severe anxiety or depression symptoms. We designed this study to evaluate these symptoms in the two groups of subjects. METHODS: In a case-control study performed in 2006, we randomly selected 32 transplant recipients and 39 hemodialysis patients. The two groups were matched for gender, age, marital status, educational background, and somatic comorbidities. Symptoms of anxiety and depression were compared between the groups using the Hospital Anxiety Depression Scale. RESULTS: Anxiety score was significantly lower among transplant recipients compared with hemodialysis patients (8.61 +/- 3.09 vs 10.41 +/- 2.77; P=.01). There was no significant difference between the two groups in the score for depression (P>.05). In transplant recipients, the severity of anxiety was higher among those with a history of graft rejection and those <35 years at the time of transplantation (P<.05). The severity of depressive symptoms was higher among subjects with lower educational status (P<.05). CONCLUSION: Depressive symptoms did not seem to improve after renal transplantation, which highlights the need for screening and appropriate treatment of depression. Transplant recipients with a history of rejection or a young age at the time of transplantation should receive more attention for psychiatric problems.

Improved mental health status in the first 2 weeks after kidney transplantation.

There is controversy whether mental health actually improves among kidney transplant recipients. The aim of this study was to investigate whether there was any significant change in mental status during the first 2 weeks after kidney transplantation. This cohort study involved 97 individuals who were transplantation candidates between 2003 and 2004. During the pretransplantation assessment, each individual completed the General Health Questionnaire (GHQ-28) and the Minnesota Multiphasic Personality Inventory, short form (MMPI). Posttransplantation subjects completed the GHQ-28 again. There were significant differences between mean total GHQ raw scores before and at 2 weeks after transplantation. Significant correlations were detected between a history of referral to a psychiatrist and a change in each of the 4 GHQ subscale scores. Our findings suggest that most kidney recipients show improved mental health in the early phase (first 14 days) after surgery. However, the results were not as positive as expected. Patients with a history of psychiatrist referral require special psychological attention.