Assessment of health-related quality of life in renal transplant recipients and dialysis patients

Health-related quality of life (HRQoL) is becoming an important outcome measure in evaluation of various forms of renal replacement therapy (RRT). The Short Form-36 (SF-36), Giessen Subjective Complaints List (GBB-24), and Zerssen's Mood Scale (Bf-S) are internationally validated questionnaires for the assessment of HRQoL. The goal of the current study was to evaluate the HRQoL of renal transplant recipients and compare it with that of patients on different forms of RRT. The study population consisted of: (1) 120 patients on hemodialysis (HD); (2) 43 patients on peritoneal dialysis (PD); (3) nine recipients who lost their grafts and went back to dialysis; (4) 120 age- and sex-matched healthy individuals (controls); and (5) 48 renal transplant recipients. The mean SF-36 scores were not significantly different between control group and transplant recipients as well as HD and PD patients including previously transplanted patients. The dialysis patients scored significantly worse in all eight SF-36 domains compared with transplant recipients and healthy subjects. In all GBB-24 components, the transplant recipients scored significantly higher than HD and PD patients. In the "fatigue tendency," "limb pain," and "cardiac complaints" components, recipients scored significantly higher than control group subjects. The mood analysis (Bf-S) showed that the scores of transplant recipients and controls did not differ, being significantly higher than those of dialysis patients. The HRQoL of patients on HD and PD were similar and lower than that of the general population. Renal transplantation significantly improved HRQoL at least to the level of healthy individuals. Graft loss was associated with significant worsening of HRQoL.