Pain Affects Health-Related Quality of Life in Kidney Transplant Recipients

Nourbala, Mohammad Hossein; Hollisaaz, M.-T.; Nasiri, Morteza; Bahaeloo-Horeh, Saeid; Najafi, Mehdi; Araghizadeh, H; Rezaie, Y.; Lak, Marzieh

doi:10.1016/j.transproceed.2007.03.004

Cited by 13 publications

(7 citation statements)

References 21 publications

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“…This corroborates the results of the study of Nourbala et al. (14) who compared the intensity of pain in HD patients, transplant recipients, and healthy persons. The results of that study showed that although pain in the kidney recipients was significantly less prevalent than in HD patients, it was more frequent than in healthy subjects.…”

Section: Discussionsupporting

confidence: 91%

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Similar prevalence but different characteristics of pain in kidney transplant recipients and chronic hemodialysis patients

Masajtis-Zagajewska

Pietrasik

Krawczyk

et al. 2010

Clinical Transplantation

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Section: Discussionsupporting

confidence: 91%

“…Moreover, most of the studies were focused on a quality of life or nonspecific symptoms related to pain than on pain itself. The same limitation refers to a few available studies on pain in the organ transplant recipients (14)(15)(16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

Similar prevalence but different characteristics of pain in kidney transplant recipients and chronic hemodialysis patients

Masajtis-Zagajewska

Pietrasik

Krawczyk

et al. 2010

Clinical Transplantation

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“…Patients taking certain types of immunosuppressant medications, for example, are at increased risk for emotion regulation difficulties, which could be exacerbated by poor sleep. Unique stressors for this population, such as medically related fatigue, pain, social and academic stress, and neurocognitive challenges, may simultaneously impact mood and quality of life, as well as concomitant sleep difficulties. Further, poor sleep quality may be cumulatively detrimental among adolescent transplant recipients who experience reduced levels of physical and psychosocial functioning due to the many stressors that they face related to living with a transplant (eg, shortened lifespan, possible need for re‐transplantation).…”

Section: Discussionmentioning

confidence: 99%

Sleep quality is associated with psychosocial functioning and health‐related quality of life in pediatric transplant recipients

Gutierrez‐Colina

Quast

Eaton

et al. 2019

Pediatric Transplantation

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This study examined patient‐reported sleep quality in a single‐center cross‐sectional sample of adolescents with solid organ transplants and evaluated associations between sleep quality, psychosocial functioning (ie, depression/anxiety symptoms), and HRQOL. Health disparities associated with minority race/ethnicity and socioeconomic variables were also examined. Sixty‐nine adolescents (M = 16.51 years; SD = 1.63) who received a solid organ transplant (kidney: n = 25; liver: n = 24; heart: n = 20) completed self‐report measures of sleep quality, psychosocial functioning, and HRQOL. Adolescent transplant recipients endorsed significantly lower levels of sleep quality (ie, falling asleep) compared with previously published norms of healthy peers (t = −3.60; P ≤ .001). Higher sleep quality was significantly associated with fewer anxiety and depressive symptoms (r = −.31 to −.40), and higher physical and psychosocial HRQOL (r = .33‐.43). Adolescents from minority backgrounds had significantly worse sleep quality compared with non‐Hispanic Whites. Adolescent transplant recipients, particularly those from minority backgrounds, may be at increased risk for experiencing poor sleep quality. Suboptimal sleep is a risk factor for higher levels of anxiety and depressive symptoms, as well as lower levels of physical and psychosocial HRQOL. Sleep is an important modifiable factor that, if improved, may contribute to lower anxiety/depressive symptoms and better HRQOL in adolescent transplant recipients.

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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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Pain Affects Health-Related Quality of Life in Kidney Transplant Recipients

Cited by 13 publications

References 21 publications

Similar prevalence but different characteristics of pain in kidney transplant recipients and chronic hemodialysis patients

Similar prevalence but different characteristics of pain in kidney transplant recipients and chronic hemodialysis patients

Sleep quality is associated with psychosocial functioning and health‐related quality of life in pediatric transplant recipients

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

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