Importance of Socioeconomic, Clinical, and Psychological Factors on Health-related Quality of Life in Adolescents After Kidney Transplant Mohammad Reza Malekahmadi, 1 Shadi Rahimzadeh, 2,3 Mohammad Lorgard Dezfuli Nejad, 2 Maryam Moghani Lankarani, 2 Behzad Einollahi, 4 Shervin Assari, 5 Abstract Objectives: Health-related quality of life after kidney transplant in adolescents is a major concern; nevertheless, there is a paucity of data on the variables that have an effect on it. This study evaluated the extent to which socioeconomic, clinical, and psychological characteristics explain the variance in the health-related quality of life of adolescent Iranian kidney transplant recipients. Materials and Methods: Into a hierarchical regression analysis, the cross-sectional socioeconomic, clinical, and psychological characteristics were entered among 55 adolescent Iranian kidney transplant recipients. Results: The relative predictive power of socioeconomic, clinical, and psychological variables with respect to health-related quality of life was 21.8% (P = .088), 21.2% (P = .014), and 27.6% (P = .001). Conclusions: Psychological factors had a greater relative predictive power in postrenal transplant health-related quality of life of adolescents than did the socioeconomic and clinical characteristics. Further research should target to improve the health-related quality of life in adolescent kidney recipients by psychological intervention. Key words: Health-related quality of life, Adolescent, Kidney transplant, End-stage renal disease Introduction Kidney transplant is the treatment of choice for adolescents with end-stage renal disease (ESRD) inasmuch as it confers freedom from dialysis, paves the way for normal growth, 1 contributes to a more regular lifestyle, 2 enhances school performance, 3 reduces cost of dialysis, 4 and alleviates family stress. 5 In Iran, about 300 adolescents have received their first renal transplant before 2003. 6 Medical modalities often tend to predicate the restoration of general health on the improvement in health-related quality of life. 7 Indeed, an evaluation of health-related quality of life carries a great deal of weight 8 to the extent that nephrologists consider health-related quality of life as a main outcome in the treatment efficiency assessment 9 of such cases as kidney transplant. 10 Unfortunately, a scarcity of data on the variables that have some bearing on health-related quality of life in renal transplanted patients has hampered efforts to carry out more detailed analyses. 11 What exacerbates the situation is the inclination on the part of researchers to lump together the data of young samples into large age groups, rendering a distinction between information on health-related quality of life in adolescence and in young adulthood difficult. 12-14 Therefore, we sought to conduct the present study in adolescent kidney-transplant recipients to answer the following question: Of the socioeconomic, clinical, and psychological factors, which one gives a better account for the changes in health-related quality of life? From the Departments of 1 Shahrekord University of Medical Sciences, Shahrekord, Iran, 2 Medicine and Health Promotion Institute, Tehran, Iran, 3 Universal Network for Health Information Dissemination and Exchange (UNHIDE), 4 Nephrology Urology Research Center, Baqiyatallah Medical Sciences University, Tehran, Iran, and the 5 Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, US, Acknowledgments: This paper is the result of a secondary analysis conducted by Universal Network for Health Information Dissemination and Exchange (UNHIDE) on an existing health data. Suggestion and running the secondary analysis as well as manuscript preparation have been done by this international network. Address reprint requests to: Mohammad Reza Malekahmadi, MD, Department of Pediatrics, Hajar Hospital, Shahrekord, Iran Phone: +98 21 44432277 Fax: +98 21 44432277 E-mail: cru_common@yahoo.com Experimental and Clinical Transplantation (2011) 1: 50-55 Copyright © Başkent University 2011 Printed in Turkey. All Rights Reserved. Article