Impact of nonspecific allograft biopsy findings in symptomatic kidney transplant recipients.

A for-cause biopsy is performed to diagnose the cause of allograft dysfunction in kidney transplantation. We occasionally encounter ambiguous biopsy results in symptomatic kidney transplant recipients. Yet, the allograft survival outcome in symptomatic recipients with nonspecific allograft biopsy findings remains unclear. The purpose of this study was to analyze the impact of nonspecific for-cause biopsy findings in symptomatic kidney transplant recipients. We retrospectively collected records from 773 kidney transplant recipients between January 2008 and October 2021. The characteristics of transplant recipients with nonspecific findings in the first for-cause biopsy were analyzed. Nonspecific allograft biopsy findings were defined as other biopsy findings excluding rejection, borderline rejection, calcineurin inhibitor toxicity, infection, glomerulonephritis, and diabetic nephropathy. The graft outcome was compared between recipients who had never undergone a for-cause biopsy and those who had a first for-cause biopsy with nonspecific findings. The graft survival in recipients with nonspecific for-cause biopsy findings was comparable to that in recipients who did not require the for-cause biopsy before and after propensity score matching. Even in symptomatic kidney transplant recipients, nonspecific allograft biopsy findings might not be a poor prognostic factor for allograft survival compared to recipients who did not require the for-cause biopsy.

Relationship between depression and health-related quality of life in older Korean patients with chronic obstructive pulmonary disease.

AIMS AND OBJECTIVES: The aims are to determine the prevalence of depression and examine its impact on the health-related quality of life (HRQoL) among older Korean patients with chronic obstructive pulmonary disease (COPD). BACKGROUND: Realising the effects of depression on HRQoL, many studies have reported the prevalence of depression and its negative impacts on HRQoL in COPD patients. However, the majority of the studies were performed in developed countries, with very few studies occurring in developing or non-developed countries. DESIGN: Survey with the comparison of HRQoL between the COPD patients with and without depression. METHODS: A total of 91 COPD patients completed the St. George respiratory questionnaire (SGRQ), Medical outcomes short form-36 (SF-36) and Beck depression inventory (BDI). RESULTS: The prevalence of depression was 15.4%. The SGRQ total and impact subscores were significantly worse in the patients with depression (p < 0.05). The physical functioning, bodily pain, vitality and general health dimensions from the SF-36 were statistically poor in the patients with depression (p < 0.05). The patients with severe and very severe lung function defects showed significantly worse total, activity and impact scores of the SGRQ and significantly poor physical functioning, role physical, bodily pain, social functioning, mental health, role emotional and general health scores on the SF-36 (p < 0.05). CONCLUSION: In South Korea, the prevalence of depression is considerable, and depression has a negative impact on the HRQoL among older COPD patients. RELEVANCE TO CLINICAL PRACTICE: The study results suggest that depression is prevalent in older COPD patients in South Korea. The presence of depression negatively impacts on the HRQoL of the COPD patients. Considering the importance of the relationship between psychological problems and HRQoL in caring for and promoting the welfare of COPD patients, this study provides fundamental information and a basis for further evaluation of this issue in developing and non-developed countries.