Nephrology Dialysis Transplantation, Volume 30, Issue suppl_3, May 2015, Pages iii495–iii496
Introduction and Aims: This sub-study of the NIHR-funded Access to Transplantation and Transplant Outcome Measures (ATTOM) programme investigated quality of life (QoL) and treatment satisfaction in patients on different treatments for chronic kidney disease.
Methods: 109 deceased donor (DD) kidney recipients, 102 live donor kidney recipients, 101 simultaneous pancreas and kidney (SPK) recipients, 100 patients awaiting kidney alone (KA) transplant, 124 patients on haemodialysis (HD) and 33 on peritoneal dialysis (PD), 28 awaiting SPK transplant, and 13 whose KA transplant failed, were recruited from Dec. 2011-Sept. 2013 and completed the Renal-Dependent Quality of Life (RDQoL) and the Renal Treatment Satisfaction Questionnaire (status; RTSQs) at 3m and 12m post-transplant/transplant failure or post-recruitment to the study. The RTSQ change version (RTSQc) was also completed at 12m comparing current with previous treatment. SPK recipients and those listed for SPK transplant completed the Audit of Diabetes-Dependent QoL (ADDQoL) and Diabetes Treatment Satisfaction Questionnaire (status; DTSQs) at 3m and 12m plus the DTSQc at 12m. Analyses included ANOVA with planned contrasts.
Results: Treatment satisfaction (RTSQs) was high but a profound negative impact of the renal condition on QoL (RDQoL) was reported by all treatment groups. Renal-dependent QoL and treatment satisfaction were similar or better in the 3 successful transplant groups at 3m compared with other groups. The 3 successful transplant groups reported improved QoL from 3-12m post-transplant (p < 0.0005), whilst those listed for a KA transplant, HD and PD patients reported stable QoL. In contrast, those awaiting SPK transplant reported worse QoL at 12m. All 3 transplant groups reported improved treatment satisfaction (RTSQs) from 3-12m compared with those awaiting KA transplant (p < 0.0005) or those on HD (p < 0.005). Live donor kidney and SPK recipients also reported improved satisfaction compared with PD (p < 0.0005). The successful transplant groups reported a greater increase in renal treatment satisfaction (RTSQc) since previous treatment than those awaiting KA transplant, those on dialysis (p < 0.005), or those awaiting SPK transplant (p = 0.019) who all showed a smaller increase. SPK recipients showed no change in diabetes-dependent QoL (ADDQoL) and diabetes treatment satisfaction (DTSQs) from 3 to 12m, but DTSQc scores showed SPK recipients were much more satisfied with their pancreas transplant than with previous diabetes treatment. The few patients whose transplants failed reported poorer QoL at 3m with further reductions at 12m, but treatment satisfaction was at least as good as other groups.
Conclusions: As expected, successful transplant significantly reduced the substantial negative impact of chronic kidney disease on QoL. Investigation of between-group differences in patient characteristics is planned to help understand why QoL and treatment satisfaction worsened over 12m in those listed for SPK transplant but not in those listed for KA transplant, or those on HD or PD.
