Health-Related Quality of Life in Kidney Transplant Patients: A Pilot Study of PROMIS-9 Surveys

Background: Health-related quality of life (HRQoL) is an important patient-reported outcome measure (PROM) but HRQoL but PROMs are not systematically captured among kidney transplant (KT) patients. Methods: We administered the 9-item Patient-Reported Outcomes Measurement Information System (PROMIS)-9 survey to a sample of KT patients (2019–2023) to assess HRQoL at different phases of care. PROMIS-9 assesses physical function, anxiety, depression, fatigue, sleep disturbance, social participation, pain interference, pain intensity and global health using single items on a Likert scale. Scores were converted to EuroQol Group (EQ-5D) HRQoL scores by standardized methods (range from 0 to 1.0, with 1.0 equating with perfect health and 0 donating ‘similar to death’ status). Results: 113 KT patients were included, with 50 surveys completed pre-KT, 55 at 6-months post-KT,and 64 at 1-year post-KT. Mean EQ-5D scores rose from 0.75 pre-KT to 0.80 and 0.83 at the 6-month and 1-year assessments, respectively (Fig.). 15 individuals completed both a pre-KT and 6-month post-KT survey, among whom there was a trend towards improved EQ-5D (overall 4.2 % change; P = 0.08). In this subset, the EQ-5D percentage change was largest in those who were age 31-44 years vs. age 19-30 [9.5% (standard deviation (SD) 8.1% vs. 2.4% (SD 5.3%)], had BMI ≥30.0 vs.25-to<30 kg/m2 [7.9% (6.3%) vs 4.0 % (5.1%)], and had kidney failure from glomerulonephritis vs. diabetes [19.9% (0%) vs. 2.2% (3.1%)]. Conclusion: PROMIS-9 is a concise tool for capturing HRQoL in KT patients. Pilot data support improved HRQoL after KT and suggest subgroups with particular improvements. Ongoing, broader study is needed to determine the value of incorporating HRQoL PROMs in routine KT patient monitoring.