[Quality of life and depression in renal transplant patients]. / Pacientu, kuriems persodintas inkstas, depresijos sunkumas ir gyvenimo kokybe.

UNLABELLED: The objective of this study was to examine the factors affecting quality of life in renal transplant patients and to evaluate the association between depression and quality of life. MATERIAL AND METHODS: A study was carried out in 61 renal transplant patients. Health-related quality of life was evaluated using the Medical Outcomes Study 36-item Short Form (SF-36) questionnaire. Depression was measured using the Beck's Depression Inventory (BDI). RESULTS: Twenty percent of the subjects had a BDI score higher than 15. The BDI score correlated inversely with these quality-of-life domains: physical functioning (r=-0.691, P<0.001), limitations in physical activities because of physical problems (r=-0.428, P=0.001), bodily pain (r=-0.662, P<0.001), and limitations in usual role activities because of emotional problems (r=-0.319, P<0.001). The BDI score also correlated with age (r=0.44, P<0.001) and serum creatinine level (r=0.453, P<0.001). Subjects with BDI score higher than 15 were significantly older (51.40+/-11.35 years vs. 42.64+/-10.89 years, P<0.05), they had higher serum creatinine levels (215.7+/-82.63 micromol/L vs. 153.2+/-50.6 micromol/L, P<0.05), lower bodily pain score (39.7+/-21.44 vs. 72.32+/-19.0, P<0.001), and lower score in limitations in usual role activities because of emotional problem (36.6+/-33.23 vs. 67.36+/-37.83, P<0.05). CONCLUSIONS: Depression was associated with a lower quality of life in four domains. Patients with depression were older and had a worse graft function.

[The beginning of kidney transplantation in Kaunas (results of Kaunas University of Medicine Hospital 2000-2004)]. / Inkstu persodinimo operaciju pradzia Kaune (2000-2004 m. Kauno medicinos universiteto kliniku inkstu persodinimo operaciju rezultatai).

During the last year 57 cadaver kidney transplantations were performed in Lithuania, 23 of them in Kaunas. The first transplantation of cadaver kidney at Kaunas University of Medicine Hospital was performed in May 2000. The purpose of the study was to analyze the results of kidney transplantations performed at Kaunas University of Medicine Hospital between May 2000 and December 2004 and to evaluate the most frequent early and late complications after transplantation and survival of the kidney transplant. During this period a total of 51 cadaver kidney transplantations were done. The mean age of patients was 38.37+/-12.45 years. 90.2% of cadaver kidneys were taken from the optimal kidney donors. The most common early complications after kidney transplantation were infections of the urinary tract (33.3%) and on the late period of kidney transplantation complications of the immunosuppressive treatment (40%) (cytomegalovirus infection, agranulocytosis). Acute rejections were in 13.7 proc. of patients. Kidney transplant survival rate at 1 and 3 years after cadaver kidney transplantation was 85%. Mortality of transplant patients was 2%.

[Dynamics of diabetic nephropathy and other complications of type I diabetes mellitus in the period of 1996-2002 (data from 2 Kaunas outpatient polyclinics)]. / Diabetines nefropatijos ir kitu cukrinio diabeto komplikaciju pokyciai 1996-2002 metais (dvieju Kauno miesto pirminiu sveikatos prieziuros centru duomenimis).

Kidney involvement in diabetes mellitus has negative impact on the outcomes of disease. Strong relationship between progressive diabetic kidney disease and the development of other diabetic complications was found by many investigators. In order to evaluate the dynamics of diabetic nephropathy in type I diabetes mellitus during 6-year period and its relationship with other diabetes mellitus complications and control of glycemia and hypertension, in 2002 we reviewed ambulatory case records of patients, who were followed by endocrinologists and who were investigated by us in 1996. During 6-year period, 5.1% from 156 pts. died and all of them had diabetic nephropathy; 26.9% of pts. moved to general practitioners and never visited endocrinologists again. Only 105 pts. remained under follow-up by endocrinologists. Their mean age 37.6+/-1.3 yrs. Out of all patients, 54% were males and 46% females. Mean diabetes mellitus duration was 19.5+/-0.9 yrs. Control of glycaemia was poor and insufficient in 2/3 of pts. HbA(1C) wasn't checked in 68.9% of pts. Control of arterial hypertension became better, but not sufficiently. During 6-year period persistent proteinuria developed in 12.1% of pts., who had no or transient proteinuria <0.5 g/l in 1996. Persistent proteinuria developed 19.9+/-1.8 yrs. after the diabetes mellitus onset and correlated with hypertension and renal insufficiency. Higher level of proteinuria was associated with worse control of glycemia. Progression of diabetic retinopathy and neuropathy over 6 yrs. were more expressed than in diabetic nephropathy. On average retinopathy developed after 14+/-1.8 yrs. after the diabetes mellitus onset, neuropathy--17.8+/-2.2 yrs., renal failure--21.1+/-2.8 yrs., heart failure--22.9+/-1.9 yrs. and arterial hypertension--12.1+/-1.3 yrs. The prevalence and time of incipient diabetic nephropathy appearance remained unknown because the test for microalbuminuria was not available in the primary health care centres.