Compliance with Lifestyle Recommendations in Kidney Allograft Recipients

Kobus, Grażyna; Małyszko, Jolanta; Puza, E.; Bachórzewska−Gajewska, Hanna; Myśliwiec, Michał

doi:10.1016/j.transproceed.2011.08.031

Cited by 32 publications

(29 citation statements)

References 15 publications

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“…[17] The results showed that most patients had good adherence to taking medication and various studies have confirmed these findings. [4131518] Patients adherence in this study was higher than that reported in the study by Shabany Hamedan et al .,[19] which might be due to increased awareness of the patients regarding the importance of taking certain medications. Patients' adherence was affected by various factors.…”

Section: Discussioncontrasting

confidence: 65%

“…[12] Therefore, patients are trained before being discharged from the hospital regarding the new lifestyle, including follow-up visits, prevention of infection, diet, use of immunosuppressive therapy, physical activity, recording self-monitoring, and sun protection items. [13] Various studies have shown that patients who undergo kidney transplantation do not follow these recommendations accurately;[1314] therefore, it is essential that health care providers, especially nurses, pay particular attention to this issue. Adherence to recommended lifestyle is affected by various factors including socioeconomic factors along with those related to treatment.…”

Section: Introductionmentioning

confidence: 99%

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Nonadherence behaviors and some related factors in kidney transplant recipients

Hedayati

Shahgholian

Ghadami

2017

Iranian J Nursing Midwifery Res

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Background:Kidney transplantation is the renal replacement therapy of choice for most patients with end-stage renal disease (ESRD), however, adherence to the recommended lifestyle is critical for a positive prognosis. The purpose of this study was to assess adherence to immunosuppressive therapy and lifestyle recommendations along with some related factors among kidney transplant patients.Materials and Methods:In this descriptive analytical study, all patients completed a questionnaire regarding medication intake and lifestyle recommendations (preventing of infection, self-monitoring, prevention of cardiovascular disease (CVD), and sun protection). The participants were divided into 4 groups according to the level of adherence (good, partial, poor, and nonadherent) indicated in their responses.Results:Most kidney recipients were adherent to their drug prescriptions, but were partial, poor, or nonadherent regarding lifestyle recommendations. Increased passage of time since transplantation and low family support and educational level resulted in nonadherence. Men showed greater adherence to medication intake than women. Patients with lower number of drugs and reported drug side-effects illustrated better adherence to medication intake. Women adhered to infection protection recommendations more than men, and older and married patients adhered to cardiovascular prevention recommendations more than others. However, younger patients showed greater adherence to self-monitoring recommendations, and singles, young individuals, and women were adherent to sun protection recommendations.Conclusions:Nonadherence is common among kidney transplant recipients. Thus, it is necessary to determine patients who are at risk of nonadherence and to introduce more educational programs to improve their adherence and their quality of life (QOL).

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Section: Discussioncontrasting

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Nonadherence behaviors and some related factors in kidney transplant recipients

Hedayati

Shahgholian

Ghadami

2017

Iranian J Nursing Midwifery Res

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“…The finding that male sex serves an independent prognostic factors for the progression to allograft failure is in line with previous studies which reported that recipient male gender confers a worse prognosis for allograft survival in a large retrospective cohort [27]. This gender differences may partially be explained by the fact that women are protected by hormones and appear to be more compliant than male recipients [28,29]. Other clinical parameters predicting outcome at the univariate analysis, i.e.…”

Section: Discussionsupporting

confidence: 89%

Proteinuria, Estimated Glomerular Filtration Rate and Urinary Retinol-Binding Protein as Clinical Predictors of Long-Term Allograft Outcomes in Transplant Glomerulopathy

Chen

Cheng

et al. 2018

Kidney Blood Press Res

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Background/Aims: We aimed to explore the associations between clinical parameters and long-term allograft outcomes in transplant glomerulopathy (TG) in a large retrospective cohort with long follow-up. Methods: Clinical and laboratory data at biopsy from 180 cases of TG with an estimated glomerular filtration rate (eGFR)> 15ml/min/1.73m² from January 2004 to December 2016 at our center were retrospectively analyzed. The main outcome of this study was initiation of replacement therapy or an eGFR declined to < 15 ml/min/1.73m². Results: During a median follow-up of 5 years (interquartile range 2.6-8.2 years), 117 cases (65.0%) achieved the combined event. Kaplan-Meier method yielded the 1-year and 5-year cumulative renal allograft survival rates after a histopathologic diagnosis of TG were 84% (95% confidence interval [CI] 81-87%) and 33% (95% CI 27–39%) respectively. In univariate analysis, allograft outcome differed significantly by eGFR, proteinuria, blood hemoglobin level, urinary retinol-binding protein (urRBP) and urinary N-acetyl-β-D-glucosaminidase (urNAG) level at the time of biopsy. Multivariate Cox analysis revealed that a higher level of eGFR was the most powerful predictor of allograft survival. Compared with those with eGFR≥60, the hazard ratio (HR) increased from 4.50 (95% CI: 1.03-19.71, p=0.0462) for patients with eGFR between 30 and 59 ml/min/1.73m² to 9.14 (95% CI 1.97-42.45, P=0.0047) when eGFR decreased to 15 to 29 ml/min/1.73m². Additionally, proteinuria and higher urRBP values (≥2.85mg/dl) were found to confer much worse survival rates for TG patients in multivariate Cox analysis. Male sex (HR 0.48, P=0.02) and HCV infection (HR 1.78, P=0.0499) were also found to be independent risk factors for worse allograft survival. Conclusion: Five clinical features—impaired renal function, higher proteinuria, higher urRBP level, male sex and HCV infection—are independent predictors of an unfavorable renal allograft outcome. urRBP is a simple and useful parameter that can add invaluable information for the clinical follow-up of patients with TG.

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“…The researchers found that self-reported non-adherence to clinic visits increased over time from the transplant (5% at 2 months, increasing to 10% at 2 years). 25 Although the incidence of clinic non-adherence was more similar to our own, the methods, population, and purpose for the analysis differed as there was no attempt to associate appointment non-adherence to graft outcomes. Other studies have defined non-adherence to clinic visits as missing >20% of visits, which differs from the cut point identified in our study.…”

Section: Discussionmentioning

confidence: 66%

The Impact of Health Care Appointment Non-Adherence on Graft Outcomes in Kidney Transplantation

Taber

Fleming

Fominaya³

et al. 2016

Am J Nephrol

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Background: Non-adherence to medication is a well-studied and known cause of late allograft loss, but it is difficult to measure and prospectively monitor. The aim of this study was to assess if appointment non-adherence was correlated with medication non-adherence and a predictor of graft outcomes. Methods: This was a longitudinal cohort study that used the National United States Renal Data System and veterans affairs health records data with time-to-event analyses conducted to assess the impact on graft and patient survival. Results: The number of transplants that were included in the analysis was 4,646 (3,656 with complete records); 14.6% of patients had an appointment no show rate of ≥12% (non-adherence). Appointment and medication non-adherence were highly correlated and both were significant independent predictors of outcomes. Those with appointment non-adherence had 1.5 times the risk of acute rejection (22.0 vs. 14.7%, p < 0.0001) and a 65% higher risk of graft loss (adjusted hazards ratio (aHR) 1.65, 95% CI 1.38-1.97, p < 0.0001). There was a significant interaction between appointment and medication non-adherence; those with appointment and medication non-adherence were at very high risk of graft loss (aHR 4.18, 95% CI 3.39-5.15, p < 0.0001), compared to those with only appointment non-adherence (aHR 1.39, 95% CI 0.97-2.01, p = 0.0766) or only medication non-adherence (aHR 2.44, 95% CI 2.11-2.81, p < 0.0001). Conclusion: These results demonstrate that non-adherence to health care appointments is a significant and independent risk factor for graft loss.

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Compliance with Lifestyle Recommendations in Kidney Allograft Recipients

Cited by 32 publications

References 15 publications

Nonadherence behaviors and some related factors in kidney transplant recipients

Nonadherence behaviors and some related factors in kidney transplant recipients

Proteinuria, Estimated Glomerular Filtration Rate and Urinary Retinol-Binding Protein as Clinical Predictors of Long-Term Allograft Outcomes in Transplant Glomerulopathy

The Impact of Health Care Appointment Non-Adherence on Graft Outcomes in Kidney Transplantation

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