Kidney Week

Abstract: PO2057

Development and Determinants of Quality of Life After Kidney Transplantation in Elderly Recipients

Session Information

• Transplantation: Clinical - Allocation, Evaluation, Prognosis, and Viral Onslaughts
  November 04, 2021 | Location: On-Demand, Virtual Only
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1902 Transplantation: Clinical

Authors

• de Boer, Silke, Universitair Medisch Centrum Groningen, Groningen, Groningen, Netherlands

Silke de Boer, MD

• Kremer, Daan, Universitair Medisch Centrum Groningen, Groningen, Groningen, Netherlands

Daan Kremer,

• Berger, Stefan P., Universitair Medisch Centrum Groningen, Groningen, Groningen, Netherlands

Stefan P. Berger,

• Bakker, Stephan J.L., Universitair Medisch Centrum Groningen, Groningen, Groningen, Netherlands

Stephan J.L. Bakker,

• Sanders, Jan-Stephan, Universitair Medisch Centrum Groningen, Groningen, Groningen, Netherlands

Jan-Stephan Sanders,

Background

Kidney transplantation is regarded as the best treatment for end-stage kidney disease, with survival benefits also in elderly patients. However, little is known regarding (determinants of) health-related quality of life (HRQoL), and changes in HRQoL in elderly kidney transplant recipients (KTR).

Methods

We used data from KTR ≥65 years old at the time of kidney transplantation, enrolled in the ongoing prospective TransplantLines Biobank and Cohort Study. Data on HRQoL were assessed using SF-36 mental and physical component scores (MCS and PCS). Side effects of immunosuppressive drugs were assessed using MTSOSD-59R questionnaires. In a subgroup with available data on HRQoL before transplantation, we investigated HRQoL trajectories.

Results

We included 111 KTR (age 70±4 years, 39% pre-emptive and 45% living procedures). At one year after transplantation, eGFR was 48±16 ml/min/1.73m, MCS was 51±8, and PCS was 52±7. MCS was lower in females (P_t-test=0.018), and in KTR that suffered from rejection in the first year (P_t-test=0.005). PCS was higher in KTR that were pre-emptively transplanted (P_t-test=0.010) and lower in those with post-transplantation diabetes mellitus (PTDM, P_t-test=0.008). Number of side-effects of immunosuppressive drugs was strongly associated with both MCS and PCS (both P_{linear regression}<0.001). Age, eGFR, hemoglobin, pre-transplant comorbidities, hospitalizations and infections in the first year were not associated with HRQoL. In 43 KTR with available data both before and after transplantation, PCS increased significantly after transplantation (48 to 52; P_{paired t-test}= 0.001, Figure 1), while MCS did not significantly improve (49 to 51; P_{paired t-test} = 0.095).

Conclusion

Medication-related side-effects, transplant rejection, transplantation after start of dialysis and PTDM were associated with worse HRQoL among elderly KTR, whereas eGFR and age were not. Moreover, HRQoL improves after kidney transplantation in KTR ≥65 years old.