Determinants of Health-related Quality of Life Post Kidney Transplantation at Kenyatta National Hospital
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Date
2023Author
Gituku, Caroline M
Type
ThesisLanguage
enMetadata
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Background:
Prevalence of chronic kidney disease has been rising globally causing a substantial burden on
healthcare resources across the globe. ESRD is coupled with reduced functional capacity and quality
of life. Kidney transplantation is the recommended treatment; however, it necessitates lifelong use of
immunosuppressive agents that are associated with side effects.
Objective: Study aim was to determine the HRQoL in kidney transplant recipients and its
determinants.
Methods: Descriptive cross-sectional study conducted at KNH transplant outpatient clinic.
Questionnaires collected data on social, economic and demographics. Clinical and laboratory
characteristics derived from medical records. HRQoL determined using the WHOQoL–BREF and
KDQoL36 questionnaire. Variables summarised using, mean and standard deviation for continuous
variables while percentages and proportions for categorical variables. HRQoL Scores vis-a-vis
continuous variables analysed using Pearson correlation. HRQoL scores versus categorical variables
analysed using the student T test /ANOVA. A 0.05 level of significance was adopted.
Outcomes: Seventy-three participants were recruited,75% were males with a mean age 46.6
(SD14.4), 65% resided in an urban setup and 42% had tertiary level education. Majority (63%) were
very satisfied with their overall HRQoL. Male participants had higher physical health scores
(65.9±7.1 vs 58.9±10.3 p0.002) while residing in an urban setup was associated with high
environmental scores (79.5±14.2 vs 71.8±12.0 p0.025). Participants with well controlled blood
pressure had high scores in social and environmental (89.7±12.9 vs 80.5±14.6 p0.016) (80.0±12.2 vs
66.5±14.6 p<0.001) respectively. Participants with HB>12g/dl had high physical and psychological
scores (59.4±12.2 vs 65.9±6.1 p0.004) (69.7±10.8 vs 77.4 ±7.3 p0.001) respectively. High scores in
physical, psychological, and environmental for participants with eGFR>45ml/min (65.9±6.4 vs
58±11.9 p0.001) (77.3±7.4 vs 68.4±10.7 p<0.001) (79.1±13 vs 68.8±14.5 p0.007) respectively.
KDQoL and WHOQoL-BREF questionnaires correlated poorly in physical (0.295 p0.011),
psychological (0.415 p <0.001) and social domains (0.298 p0.011).
Conclusions: Transplant recipients on follow-up at KNH transplant clinic are satisfied with their
HRQoL. Factors associated are male gender, residing in urban setup, eGFR>45ml/min, HB>12g/dl
and BP<130/80. The KDQoL and WHOQoL- BREF questionnaires correlate poorly and should be
used separately.
Recommendations: Better HRQoL in KTR thus transplantation should be recommended for eligible
patients with ESRD. Further longitudinal studies are required to test for these associations
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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