Understanding Health-Related Quality of Life in Kidney Transplant Recipients: The Role of Symptom Experience and Illness Perceptions

Yiman Wang; Paul Van Der Boog; Marc H Hemmelder; Friedo W Dekker; Aiko De Vries; Yvette Meuleman

doi:10.3389/ti.2023.10837

Understanding Health-Related Quality of Life in Kidney Transplant Recipients: The Role of Symptom Experience and Illness Perceptions

Transpl Int. 2023 Apr 13:36:10837. doi: 10.3389/ti.2023.10837. eCollection 2023.

Authors

Yiman Wang¹, Paul Van Der Boog², Marc H Hemmelder³, Friedo W Dekker¹, Aiko De Vries², Yvette Meuleman¹

Affiliations

¹ Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, Netherlands.
² Division of Nephrology, Department of Internal Medicine, Leiden University Medical Center (LUMC), Leiden, Netherlands.
³ Department of Nephrology, Maastricht University Medical Centre, Maastricht, Netherlands.

Abstract

The purpose of our article is to investigate the impact of symptom experience on health related quality of life (HRQOL) in kidney transplant recipients (KTRs) and whether illness perceptions mediated this impact. Symptom experience, illness perceptions, and HRQOL were measured at transplantation and 6 weeks after transplantation in KTRs in an ongoing Dutch cohort study. Multivariable linear regression models were used for the analysis. 90 KTRs were analyzed. Fatigue and lack of energy were the most prevalent and burdensome symptoms at transplantation. Mental HRQOL at 6 weeks after transplantation was comparable to that of the general Dutch population (mean [standard deviation, SD]: 49.9 [10.7]) versus 50.2 [9.2]), while physical HRQOL was significantly lower (38.9 [9.1] versus 50.6 [9.2]). Experiencing more symptoms was associated with lower physical and mental HRQOL, and the corresponding HRQOL reduced by -0.15 (95%CI, -0.31; 0.02) and -0.23 (95%CI, -0.42; -0.04) with each additional symptom. The identified mediation effect suggests that worse symptom experiences could cause more unhelpful illness perceptions and consequently lead to lower HRQOL. Illness perceptions may explain the negative impact of symptom experience on HRQOL. Future studies at later stages after kidney transplantation are needed to further explore the mediation effect of illness perceptions and guide clinical practice to improve HRQOL.

Keywords: adult; health related quality of life; illness perceptions; kidney transplantation; symptom experience.

MeSH terms

Cohort Studies
Humans
Kidney Transplantation*
Longitudinal Studies
Quality of Life*
Surveys and Questionnaires

Grants and funding

The authors declare that this study received funding from Astellas Pharma B.V. and Chiesi Pharmaceuticals B.V., Netherlands. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication. YW is supported by a scholarship (No. 201706270194) from the Chinese Scholarship Council. YM is supported by a grant from the Dutch Kidney Foundation (No. 17SWO09).