Changes in Health-Related Quality of Life in Greek Adult Patients Two Years after Successful Renal Transplantation

Balaska, Aikaterini; Pistolas, D.; Koukoulaki, Maria; Alassas, Dimitris; Drakopoulos, S.; Kaklamanos, Ioannis; Bonatsos, G.; Birbas, Kostantinos

doi:10.1515/bj-2016-0007

Cited by 22 publications

(37 citation statements)

References 14 publications

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“…Este hallazgo también fue observado en un estudio realizado por Ortega et al, en España en 2009 (26) , en donde la CVRS estaba asociada con la edad, específicamente en edades avanzadas. Otro estudio realizado con 85 pacientes en Grecia también encontró asociación significativa con esta variable, pero en este caso una mejor calidad de vida estaba asociada a una menor edad del paciente (27) .…”

Section: Discussionunclassified

“…Un hallazgo contrario es lo observado por Ponto (33) , quien reportó que tanto a corto plazo (de 0 a 6,9 meses) como a largo plazo (más de 36 meses) los pacientes experimentan una mejora en la calidad de vida, mientras que en el tiempo intermedio de 7 a 36 meses, el paciente presenta un deterioro de la misma. Por su parte, Balaska et al (27) , encontraron que antes de completar el año de trasplantado y después de un año, la CVRS mejora.…”

Section: Discussionunclassified

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Calidad de vida en pacientes trasplantados renales de una institución prestadora de servicios de salud en Medellín, Colombia

Hincapie¹,

Becoche²,

Zapata³

2017

Rev. Univ. salud

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Calidad de vida en pacientes trasplantados renales de una institución prestadora de servicios de salud en Medellín, ColombiaQuality of life in transplanted renal that consulted in an institution of health in Medellin, Colombia AbstractIntroduction: Renal transplantation performed on patients with chronic renal disease (CRD) stage five, is an alternative treatment that prolongs survival, reduces morbidity, accelerate social and medical rehabilitation. However it is necessary to carry out studies to evaluate the quality of life of these patients. Objective: Establishing the socio-demographic, clinical and service characteristics of the health insurer that explain the life quality of kidney transplanted patients who consulted a health institution in Medellin in 2016. Materials and methods: Quantitative and transversal survey carried out in 228 patients to whom the SF-36 instrument were applied. There were calculated the statistical tests of Kolmogorov Smirnov for normality, U de Mann Whitney, Kruskal Wallis and the Spearman correlation coefficient. In the multivariate analysis the median regression model was selected. Results: 50% of the patients got 83.3 or less in its life quality score. The multivariate regression model shown significant differences in the time variables after transplantation and readmission to hospital in the last year; by each readmission to hospital, the values of life quality decreased in 3.82 points; according to the time after the transplantation, it was found that going from a state where the patient has a term between 7 and 36 months, to a

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Section: Discussionunclassified

Calidad de vida en pacientes trasplantados renales de una institución prestadora de servicios de salud en Medellín, Colombia

Hincapie¹,

Becoche²,

Zapata³

2017

Rev. Univ. salud

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“…Almost one in four ESRF patients refused to perform renal transplantation. Several studies pointed out that renal transplantation is associated with better quality of life when it compare with dialysis [6]- [8]. However, there were many studies reported increase number of patients who are refusing renal transplantation.…”

Section: Discussionmentioning

confidence: 99%

Why Did Sudanese End Stage Renal Failure Patients Refuse Renal Transplantation?

Banaga¹,

Mohammed²,

Siddig³

et al. 2015

OJNeph

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Renal transplantation remains the most effective treatment of End Stage Renal Failure (ESRF). In this cross sectional study we explore the reasons behind refusal of renal transplantation among adults' Sudanese haemodialysis patients. The subjects of the study are ESRF adults' patients on regular haemodialysis treatment in 15 haemdoialysis centres in Khartoum/Sudan. All patients who are on regular haemodialysis were interviewed by questionnaire to explore the reasons of refusal of renal transplantation. A total of 1583 ESRF adults' patients on regular haemodialysis have been participated in the study, 381 (24.1%) patients refused kidney transplantation. The mean age of patients refusing kidney transplantation was (58.5 + 15.1 years); 77.4% of them were ≥50 years old, 59.2% were males and 88.1% were unemployed, patients older than 50 years old and unemployed are tend to refuse renal transplantation (P < 0.001). The main reason of refusal was that the patients refuse to accept kidney from living donors (34.8%). 17.6% of patients decline kidney transplantation because of financial reason, 18.1% of patients refused to do transplantation because of fear of transplant surgery, 15.7% of patients believe that kidney transplantation is against their religious values, 11.9% of patients refused transplantation because they don't have enough knowledge on renal transplantation, only 0.5% of patients refuse transplantation because of side effect of immunosuppressive drugs. In conclusion, in this study we found that elderly and unemployed ESRF patients tend to refuse renal transplantation, the most important * Corresponding author. A. S. Banaga et al. 36reason behind refusal of renal transplantation is refusal of accepting kidney donation from living related donors. This reflects the need for development of cadaveric donors program in the Sudan. ESRF patients need education and counseling on renal transplantation.

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“…20,[43][44][45] Unfortunately, data relating specifically to quality of life are currently available only in the adult population, among whom there are clear quality-of-life improvements from having a functioning kidney transplant compared with being on dialysis. [46][47][48][49][50][51][52] Significance for the NHS Treatment for ESRD is considered resource-intensive for the NHS because current costs have been estimated to use 1-2% of the total NHS budget to treat 0.05% of the population (both adult and child/adolescent). 53 Based on data from the Department of Health, it is estimated that in 2008/9, the total expenditure on 'renal problems' in England was £1.3B, representing 1.4% of the NHS expenditure.…”

Section: Significance For Patientsmentioning

confidence: 99%

Immunosuppressive therapy for kidney transplantation in children and adolescents: systematic review and economic evaluation

Haasova

Snowsill

Jones-Hughes

et al. 2016

Health Technol Assess

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BackgroundEnd-stage renal disease is a long-term irreversible decline in kidney function requiring kidney transplantation, haemodialysis or peritoneal dialysis. The preferred option is kidney transplantation followed by induction and maintenance immunosuppressive therapy to reduce the risk of kidney rejection and prolong graft survival.ObjectivesTo systematically review and update the evidence for the clinical effectiveness and cost-effectiveness of basiliximab (BAS) (Simulect,®Novartis Pharmaceuticals) and rabbit antihuman thymocyte immunoglobulin (Thymoglobuline,®Sanofi) as induction therapy and immediate-release tacrolimus [Adoport®(Sandoz); Capexion®(Mylan); Modigraf®(Astellas Pharma); Perixis®(Accord Healthcare); Prograf®(Astellas Pharma); Tacni®(Teva); Vivadex®(Dexcel Pharma)], prolonged-release tacrolimus (Advagraf,®Astellas Pharma); belatacept (BEL) (Nulojix,®Bristol-Myers Squibb), mycophenolate mofetil (MMF) [Arzip®(Zentiva), CellCept®(Roche Products), Myfenax®(Teva), generic MMF is manufactured by Accord Healthcare, Actavis, Arrow Pharmaceuticals, Dr Reddy’s Laboratories, Mylan, Sandoz and Wockhardt], mycophenolate sodium, sirolimus (Rapamune,®Pfizer) and everolimus (Certican,®Novartis Pharmaceuticals) as maintenance therapy in children and adolescents undergoing renal transplantation.Data sourcesClinical effectiveness searches were conducted to 7 January 2015 in MEDLINE (via Ovid), EMBASE (via Ovid), Cochrane Central Register of Controlled Trials (via Wiley Online Library) and Web of Science [via Institute for Scientific Information (ISI)], Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and Health Technology Assessment (HTA) (The Cochrane Library via Wiley Online Library) and Health Management Information Consortium (via Ovid). Cost-effectiveness searches were conducted to 15 January 2015 using a costs or economic literature search filter in MEDLINE (via Ovid), EMBASE (via Ovid), NHS Economic Evaluation Databases (via Wiley Online Library), Web of Science (via ISI), Health Economic Evaluations Database (via Wiley Online Library) and EconLit (via EBSCOhost).Review methodsTitles and abstracts were screened according to predefined inclusion criteria, as were full texts of identified studies. Included studies were extracted and quality appraised. Data were meta-analysed when appropriate. A new discrete time state transition economic model (semi-Markov) was developed; graft function, and incidences of acute rejection and new-onset diabetes mellitus were used to extrapolate graft survival. Recipients were assumed to be in one of three health states: functioning graft, graft loss or death.ResultsThree randomised controlled trials (RCTs) and four non-RCTs were included. The RCTs only evaluated BAS and tacrolimus (TAC). No statistically significant differences in key outcomes were found between BAS and placebo/no induction. Statistically significantly higher graft function (p < 0.01) and less biopsy-proven acute rejection (odds ratio 0.29, 95% confidence interval 0.15 to 0.57) was found between TAC and ciclosporin (CSA). Only one cost-effectiveness study was identified, which informed NICE guidance TA99. BAS [with TAC and azathioprine (AZA)] was predicted to be cost-effective at £20,000–30,000 per quality-adjusted life year (QALY) versus no induction (BAS was dominant). BAS (with CSA and MMF) was not predicted to be cost-effective at £20,000–30,000 per QALY versus no induction (BAS was dominated). TAC (with AZA) was predicted to be cost-effective at £20,000–30,000 per QALY versus CSA (TAC was dominant). A model based on adult evidence suggests that at a cost-effectiveness threshold of £20,000–30,000 per QALY, BAS and TAC are cost-effective in all considered combinations; MMF was also cost-effective with CSA but not TAC.LimitationsThe RCT evidence is very limited; analyses comparing all interventions need to rely on adult evidence.ConclusionsTAC is likely to be cost-effective (vs. CSA, in combination with AZA) at £20,000–30,000 per QALY. Analysis based on one RCT found BAS to be dominant, but analysis based on another RCT found BAS to be dominated. BAS plus TAC and AZA was predicted to be cost-effective at £20,000–30,000 per QALY when all regimens were compared using extrapolated adult evidence. High-quality primary effectiveness research is needed. The UK Renal Registry could form the basis for a prospective primary study.Study registrationThis study is registered as PROSPERO CRD42014013544.FundingThe National Institute for Health Research HTA programme.

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Changes in Health-Related Quality of Life in Greek Adult Patients Two Years after Successful Renal Transplantation

Cited by 22 publications

References 14 publications

Calidad de vida en pacientes trasplantados renales de una institución prestadora de servicios de salud en Medellín, Colombia

Calidad de vida en pacientes trasplantados renales de una institución prestadora de servicios de salud en Medellín, Colombia

Why Did Sudanese End Stage Renal Failure Patients Refuse Renal Transplantation?

Immunosuppressive therapy for kidney transplantation in children and adolescents: systematic review and economic evaluation

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