Health-Related Quality of Life and Associated Factors among Renal Transplant Recipients in the Largest Kenyan Public Hospital

Abstract

Background: Health related quality of life is an important indicator of the outcome of a major therapeutic intervention. Lack of health related quality of life data following renal transplantation in resource-constrained countries results in poor disease management. Study Objective: To assess the health-related quality of life and associated factors among renal transplant recipients at Kenyatta National Hospital. Methodology: A cross-sectional descriptive study involving 80 sequentially sampled patients was carried out for three consecutive months at the renal transplant clinic within Kenyatta National Hospital. Health related quality of life data were collected using the globally accepted Kidney Transplant Questionnaire-25 and analyzed using Stata version 13 at p < 0.05. Associations were determined between patients’ clinical variables and health-related quality of life scores. Linear regression analysis determined the extent to which the clinical variables influenced health related quality of life scores. Results: The mean age of the participants was 45.4(±14.7). The overall health related quality of life score was 5.19(±0.78). Forgetfulness (35.0%) was the most bothersome feature and 73.8% of the participants scored 7 on appearance domain while 30.0 % scored 5 on fatigue dimension. A third of the patients scored 5 on uncertainty dimension while 32.5% scored 6 on emotions domain. The highest mean score was in the appearance domain, 6.62(±0.60) and the lowest was on uncertainty domain, 4.28(±1.12). Patients with comorbid diabetes and hypertension had statistically significantly lower scores [4.79 (±0.82)] (p=0.017) and comorbidity with diabetes decreased the scores by 11.67 units {95% CI (-21.283, -2.064)}. Conclusions: Health related quality of life among the renal transplant recipients was good. The low scores in uncertainty/fear and comorbid diabetes/hypertension reflect distress suggesting that clinicians should incorporate psychosocial care among renal transplant recipients. Future studies should correlate scores before and after transplantation to ascertain the impact of transplantation on quality of life.