Factors associated with health-related quality of life after successful kidney transplantation: a population-based study Maristela Bohlke Æ Stela S. Marini Æ Marcos Rocha Æ Lisoneide Terhorst Æ Rafael H. Gomes Æ Franklin C. Barcellos Æ Maria Claudia C. Irigoyen Æ Ricardo Sesso Accepted: 19 August 2009 / Published online: 10 September 2009 Ó Springer Science+Business Media B.V. 2009 Abstract Introduction Kidney transplantation improves the quality of life of end-stage renal disease patients. The quality of life benefits, however, pertain to patients on average, not to all transplant recipients. The aim of this study was to identify factors associated with health-related quality of life after kidney transplantation. Methods Population-based study with a cross-sectional design was carried out and quality of life was assessed by SF-36 Health Survey Version 1. A multivariate linear regression model was constructed with sociodemographic, clinical and laboratory data as independent variables. Results Two hundred and seventy-two kidney recipients with a functioning graft were analyzed. Hypertension, diabetes, higher serum creatinine and lower hematocrit were independently and significantly associated with lower scores for the SF-36 oblique physical component summary (PCSc). The final regression model explained 11% of the PCSc variance. The scores of oblique mental component summary (MCSc) were worse for females, patients with a lower income, unemployed and patients with a higher serum creatinine. The regression model explained 9% of the MCSc variance. Conclusions Among the studied variables, comorbidity and graft function were the main factors associated with the PCSc, and sociodemographic variables and graft function were the main determinants of MCSc. Despite compre- hensive, the final regression models explained only a little part of the heath-related quality of life variance. Additional factors, such as personal, environmental and clinical ones might influence quality of life perceived by the patients after kidney transplantation. Keywords Health-related quality of life Á Kidney transplantation Á Population-based study Á Outcome Introduction Kidney transplantation is currently the most cost-effective treatment for end-stage renal disease [1–3] as it presents a lower cost and provides survival advantages [4] and a better health-related quality of life (HRQoL) [1, 2, 5, 6] if compared with dialysis. Although the HRQoL advantages of the renal trans- plantation are well established [1, 7–12], it is also clear that these HRQoL benefits refer to patients on average. Large differences in HRQoL are often observed within specific transplant cohorts. A significant (minority) proportion of patients of any given sample may not show improvements in HRQoL. The life after the renal transplant presents negative aspects as well, such as the strict immunosup- pressive regimen and its side effects, frequent medical visits, rejection episodes, infections and the uncertainty and anxiety concerning the potential loss of the graft. Therefore, one of the most important issues for the future is to more clearly specify the full range of personal, environmental and clinical factors that retard or enhance HRQoL outcomes. A better understanding of these factors’ roles is essential for M. Bohlke (&) Á S. S. Marini Á M. Rocha Á L. Terhorst Á R. H. Gomes Á F. C. Barcellos Universidade Cato ´lica de Pelotas, Pelotas, Brazil e-mail: mbohlke@conesul.com.br M. C. C. Irigoyen Heart Institute, University of Sa ˜o Paulo, Sa ˜o Paulo, Brazil M. C. C. Irigoyen Á R. Sesso Federal University of Sa ˜o Paulo, Sa ˜o Paulo, Brazil 123 Qual Life Res (2009) 18:1185–1193 DOI 10.1007/s11136-009-9536-5