Health-related quality of life in kidney transplant patients with diabetes

ObjectiveWe sought to assess the disutility associated with diabetes in the kidney transplant population. MethodsWe enrolled 233 kidney transplant recipients age 18-74 from a Midwestern hospital outpatient department. Recipients with multiple or multi-organ transplants, those with laboratory evidence that suggests acute cellular damage (creatinine-kinase>200U/L), or a diagnosis of acute renal failure or acute rejection were excluded from the analysis (n=33). Participants health-related quality of life (HRQOL) were evaluated using the Euro-QoL-5 Dimension (EQ-5D), Health Utility Index Mark III (HUI-III), and the Short Form-6D (SF-6D), which was calculated from the generic section (SF-12) of the Kidney Disease Quality of Life 36 (KDQOL-36). We estimated health utilities associated with diabetes using general linear modeling after adjusting for demographic, socioeconomic, and clinical characteristics. ResultsThe adjusted health disutilities associated with diabetes were clinically and statistically significant: EQ-5D (=0.05; p<0.01), HUI-III (=0.09; p<0.01), and SF-6D (=0.04, p<0.01). There was no difference between diabetic patients with good glycemic control (mean serum glucose <126mg/dL in the three months prior to enrollment) and patients with poor glycemic control. ConclusionsAmong kidney transplant patients between the ages of 18-74, non-diabetics have significantly higher HRQOL scores on the EQ-5D, HUI-III, and SF-6D compared with patients with diabetes.