Gastrointestinal symptoms impair quality of life in Italian renal transplant recipients but are under-recognized by physicians

Transpl Int. 2010 Nov;23(11):1126-34. doi: 10.1111/j.1432-2277.2010.01115.x. Epub 2010 Aug 19.

Abstract

We assessed patient- and physician-reported prevalence of gastrointestinal symptoms and their impact on quality of life (QOL) in Italian renal transplant recipients with stable graft function. Patients ≥18years with a renal allograft functioning for ≥6months and stable serum creatinine levels of <2.5mg/dl were enrolled. Physicians and patients completed an Italian translation of the Gastrointestinal Symptom Rating Scale (GSRS) and Gastrointestinal Quality of Life Index (GIQLI) questionnaires. The average time since transplantation (n=1130) was 5.9years. Forty-two immunosuppressant drug regimens were reported. The top three regimens (cyclosporine/mycophenolate mofetil/steroids; tacrolimus/mycophenolate mofetil/steroids; cyclosporine/steroids) accounted for approximately 40% of patients. In the physician interview, 39.2% of patients had ≥1 gastrointestinal symptom vs. 88.3% of patients in the self-administered questionnaire. The prevalence of GSRS symptoms was similar for each of the most frequently prescribed immunosuppressant drug regimens. GIQLI total score was significantly poorer in patients with versus those without gastrointestinal symptoms (121.8±17.6 vs. 138.4±3.7; P<0.0001), and there was a strong inverse correlation between GIQLI and patient-reported GSRS scores (Pearson's correlation coefficient -0.816; P<0.0001). Gastrointestinal symptoms are frequent in renal transplant patients, are under-evaluated by physicians and may adversely impact on patient QOL.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cyclosporine / adverse effects
  • Diagnostic Errors
  • Female
  • Gastrointestinal Diseases / chemically induced*
  • Gastrointestinal Tract / drug effects
  • Gastrointestinal Tract / physiopathology
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Italy
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / methods
  • Male
  • Mycophenolic Acid / adverse effects
  • Mycophenolic Acid / analogs & derivatives
  • Prospective Studies
  • Quality of Life
  • Steroids / adverse effects
  • Tacrolimus / adverse effects
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • Steroids
  • Cyclosporine
  • Mycophenolic Acid
  • Tacrolimus