Psychische Auswirkungen einer Nierentransplantation

Kidney transplantation has emerged as a major therapeutic regimen of end stage renal failure. Surprisingly, data on its psychological implications are scarce. This study was designed to gain insights into the psychological self-assessment of kidney graft. 626 kidney graft recipients were handed a questionnaire, focusing on quality of life after transplantation, impairment by side effects of immunosuppression and attitude towards graft, donor and transplantation. The questionnaire had a rating scale from 0 to 4 (0 meaning denial, 4 approval of the quoted statement). 316 (147 female, 169 male) out of 626 patients responded to the questionnaire. The feedback rate was 50.5%. The patients had a mean age of 48.1 ± 13.1 years and had been transplanted 5.2 ± 3.8 years before. Since transplantation the majority of patients (87.5%) experienced a marked improvement of life quality. This was particularly attributed to an improved physical (40.8%), mental (73.1%) and sexual capacity (48.0%). These improvements were not related to renal function, hemoglobin or duration of transplantation. Only 43.6% of patients between 16 and 60 years thought of themselves as being able to perform a full time job. 31.0% reflected intensively on their transplantation, contrasting to a minimal number of patients who reflected on their respective graft (2.2%) and donor (7.4%). As a consequence of immunosuppression 34.3% of patients gained more than 5 kg of weight or suffered from osteoporosis (8,3%), joint pains (15.2%), hypertrichosis (13.7%) or gingival hyperplasia (12.7%). In conclusion, kidney transplantation improved life quality in many fields, but side effects of immunosuppression remain a problem.