Quality of Life in Kidney Transplantation

Kidney transplantation is the best modality of renal replacement for patients onhemodialysis for end-stage renal disease. 1-year graft and patient survival, thanks to theimprovement in surgical techniques and immunosuppression management, is now up to90%. In this view, the attention of the clinics has shifted toward health-related quality of life(HRQOL) as the best indicator of medical care in kidney transplant recipients. A number oftools have been suggested for this purpose, but the 36-item short-form has been widelyadopted as indicator of quality of life in this population of transplanted patients. In general,HRQOL assessment improves after transplantation in functional and physical domains whencompared with dialysis, but kidney recipients scored worse than the healthy general population.HRQOL may be negatively influenced by several factors, including co-morbidity conditions,kidney function, employment status and immunosuppressive medications side effects.Perceived physical appearance, issues related to sexuality, stress anxiety and even guilty maycomplicate the emotional and psychological status of kidney transplant recipients. Manyevents, such as non-adherence to treatment, especially in pediatric and adolescent population,may be significantly influenced by HRQOL. In this view, there is a clear need to adoptstandardized methodologies to improve our ability to identify the population of recipientsin whom the HRQOL may be worse, in order to provide them with a patient-centered medicaland psychological support.