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Quality of life after organ transplantation in type 1 diabetics with end‐stage renal disease
Author(s) -
Sureshkumar Kalathil K,
Patel Bhavesh M,
Markatos Angelo,
Nghiem Dai D,
Marcus Richard J
Publication year - 2006
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2005.00433.x
Subject(s) - medicine , end stage renal disease , quality of life (healthcare) , diabetes mellitus , transplantation , dialysis , kidney disease , pancreas transplantation , stage (stratigraphy) , urology , hemodialysis , surgery , kidney transplantation , endocrinology , nursing , paleontology , biology
Quality of life (QOL) should be an important consideration while choosing therapeutic options for patients with type 1 diabetes mellitus (DM) and end‐stage renal disease (ESRD) including dialysis, cadaver (CKT) or living kidney transplant (LKT) or simultaneous pancreas–kidney (SPK) transplant. Methods: QOL was assessed in four groups of patients with history of type 1 DM and ESRD: recipients of SPK (n = 43), CKT (n = 43), LKT (n = 11) and wait listed (WL) patients (n = 23). Diabetes Quality of Life (DQOL), Short Form‐36 (SF‐36) and Quality of Well‐Being (QWB) questionnaires were utilized. A subset of SPK (n = 19) and CKT (n = 12) recipients underwent longitudinal QOL evaluation. Results: On DQOL questionnaire, SPK group had better satisfaction subscore compared with CKT (1.8 ± 0.5 vs. 2.2 ± 0.6, p < 0.01) LKT (1.8 ± 0.5 vs. 2.4 ± 0.7, p < 0.05) and WL (1.8 ± 0.5 vs. 2.6 ± 0.6, p < 0.001) groups and better impact subscore compared with CKT (1.7 ± 0.6 vs. 2.1 ± 0.6, p < 0.05) and WL (1.7 ± 0.6 vs. 2.3 ± 0.6, p < 0.01) groups. There were no significant differences on physical/mental composite scores of SF‐36. QWB score was better in SPK group vs. WL group (0.62 ± 0.11 vs. 0.55 ± 0.04, p < 0.05). Longitudinal decline in satisfaction (2.3 ± 0.5 vs. 2.6 ± 0.9, p = 0.058) and impact (2.0 ± 0.5 vs. 2.2 ± 0.5, p = 0.019) subscores of DQOL were noted in CKT group. There were no significant changes in the composite scores of SF‐36 in both groups. QWB scores declined in the CKT group (0.67 ± 0.10 vs. 0.61 ± 0.05, p = 0.01). Conclusion: QOL was better in type 1 diabetics with ESRD following transplantation when compared with remaining on WL. SPK transplantation had significant positive effect on diabetes‐related QOL which was sustained longitudinally but it was difficult to show an overall improvement in general QOL.