Does Graft Failure After Kidney Transplantation Affect Quality of Life?

Background: The purpose of this study is to understand post-transplant patients' quality of life (QOL) experiences and the whole situation after returning to dialysis care following graft failure. Methods: We compared patients with graft failure who returned to dialysis with those who awaited a new kidney transplantation (KT) or patients who had only chronic maintenance hemodialysis (HD), not for KT. To be included in the study, patients had to be between 21 and 70 years old, have been receiving HD for over three months. Patients with severe co-morbidities or who were hospitalized in the 4 weeks before enrolment were excluded. All patients signed a consent form. The study made use of the Kidney Disease Quality of Life-Short Form (KDQOL-SF™) version 1.3 (Arabic language). Results: This study included 100 HD patients (57 males, 43 females), aged 21-70 years (mean = 48.1 ± 11.3 years). In terms of age, the distribution varied significantly, with the maintenance HD group having a larger representation of individuals in the 51-70 age range (35 out of 67) compared to the other two groups, which had a greater proportion of younger individuals. The mean duration on dialysis was 3.8 ± 3.2 years, with a shorter duration for patients awaiting KT (P>0.05). We observed that the highest QOL score was in patients with graft failure for the psychological and spiritual subscales, followed by the family subscale, but with no significant differences between the studied groups (P>0.05). The Pearson's correlation coefficients among four key domains for the Graft Failure group: Health and Functioning, Social and Economic factors, Psychological/Spiritual well-being, and Family relationships, reveal strong positive correlations with Health and Functioning (r = 0.877, p < 0.001), Social and Economic factors (r = 0.852, p < 0.001), Psychological/Spiritual well-being (r = 0.611, p = 0.007), and Family relationships (r = 0.773, p < 0.001). Conclusion: These findings suggest that within the graft failure group, higher scores in one domain tend to be associated with improvements or higher scores in the others, highlighting the interconnectedness of these aspects of life for individuals experiencing graft failure. It seems that one strategy of family and friends’ support plays an important role in the adaptation strategy and may improve QOL in patients with graft failure.