Assessment of health-related quality of life in renal transplant and hemodialysis patients using the SF-36 health survey

Objectives. To determine whether the health-related quality of life (HQOL) for renal transplant patients improved using SF-36 survey scores and to exa mine which clinical measures after renal transplantation are connected to a spects of their HQOL. Methods. A total of 117 renal transplant patients and 114 hemodialysis pati ents, including 49 awaiting transplantation and 65 not awaiting transplanta tion, were included in this study. The scale scores of the SF-36 survey con cerning HQOL were compared between the two groups of patients. The relation ships of the clinical episode and complications with the scale scores were examined. Results. The renal transplant patients had significantly higher scores in t he physical functioning, bodily pain, general health, and social functionin g scales than did the hemodialysis patients. The role-physical functioning, bodily pain, and social functioning scales of the transplant patients were significantly higher than those of the hemodialysis patients not awaiting transplantation. In contrast, the scores, except for that of general health , of the transplant patients were not significantly different from those of the hemodialysis patients awaiting transplantation. Multiple regression an alysis demonstrated that the scale scores of physical functioning, general health, and vitality were significantly dependent on the serum level of cre atinine in the renal transplant patients (P <0.05). The scores of physical functioning and general health of the patients with a creatinine level >2 m g/dL were significantly lower than those of the patients with 1 mg/dL < cre atinine level less than or equal to 1.5 mg/dL or a creatinine level less th an or equal to 1 mg/dL (P <0.05). An episode of hospitalization was not rel ated to the scale scores, but, an instance of rejection had an effect on th e scores of social functioning and role-emotional functioning. Conclusions. The SF-36 health survey is a short but comprehensive scale for evaluating a patient's HQOL. The renal transplant patients' HQOL improved compared with that of the hemodialysis patients. The most important factor affecting HQOL was the serum creatinine level at the time of testing with t he SF-36 survey. UROLOGY 56: 201-206, 2000. (C) 2000, Elsevier Science inc.