Quality of life in end stage renal disease patients after successful penal transplantation Tanzania experience

Abstract

CKD and eventually ESRD are becoming markedly increased across the world, The cost for RRT is becoming so prohibitive more so in developing countries like Tanzania, HRQoL is increasingly being used to assess chronic clinical conditions, CKD being one of them, HRQoL in nephrology involves determining efficiency and effectiveness of different forms of R..~T; evaluating the efficiency and effectiveness of different types of other treatments applied to patients e.g. immunosuppressives, and follow-up of the evolution of individual patients, Objectives; To determine the quality of life in ESRD patients after successful renal transplantation in Tanzania, Study site and design; Cross- sectional study involving all renal transplanted patients in Tanzania,

transplanted patients, Information recorded includes demographic data, clinical characteristics and HRQoL using the SF-36 tool. Results; The study sample included 44 renal transplanted patients of whom most were males 31(81.8%), married 37(84.1%), college educated 31(70.5%) and overweight 29(65.9%). Their age ranged from 22 to 66 years with a mean of 45.9 years ± 10.51. Diseases leading to ESRD included Hypertension 25(58.8%), Glomerulonephritis 7(15.9:>0), both diabetes and hypertension 6(13.6%), Polycystic disease 3(6.8%), diabetes alone 2(4.5%). Most transplants were sponsored by government 28(63.6%). Others included Employer or insurance 11 (25.0%) and self or family 5(11.4%).

vu Most renal transplanted patients were on cyclosporine based immunosupression 20(45.5%). 11(25.0%) were on Tacrolimus, 7(15.9%) on Sirolimus and 4(9.1%) Azathioprine based immunosuppression. Generally the HRQoL ESRD patients in Tanzania improved after transplantation. All 8 domains except 1 had total score above 50%. Physical Functioning =75%, Bodily Pain = 88.6%, General Health =73%, Vitality = 86.4%, Social Functioning =84.1 %, Role Emotional = 52.3%, Mental Health = 95.5% and Role- Physical = 45%. Some characteristics had statistical significant correlation to HRQoL like Age (p< 0.043), Marital status (p< 0.036), Education (p< 0.002), Employment (p < 0.008), serum Creatinine (p< 0.032), BUN (p <0.021), Immunosuppressives (p <0.028), DBP (p< 0.000), Haemoglobin (p< 0.038), Living donation ( p< 0.05) and Smoking (p< 0.038). Random Blood Sugar (p<0.06), BMI (P<0.53), HLA (0.53), Time since Transplantation were not statistically significantly associated to HRQoL. Likewise serum lipids (p< 0.356), serum protein (0.734) and serum albumin (p<0.141) were

(p< 0.51), donor relation (p< 0.66) and sex (p<0.30) were also not statistically related to HRQoL. Conclusion; ESRD patients HRQol improves after renal transplantation. However transplantation is thus expensive and emphasis should be put on CKD prevention.