Perceived availability or receipt of tangible or instrumental social support has generally been associated with favorable outcomes in kidney transplant recipients, yet there has been insufficient attention in the literature to other social relationship processes beyond support that may contribute to mental and physical health. The overall objective of the current study was to examine whether specific dimensions of relationship quality, such as emotional closeness, sexual relations, support transactions, respect/acceptance, and conflict/negative communication, within the context of a close interpersonal relationship, were associated with psychosocial and medical outcomes in kidney transplant recipients when accounting for the effects of global social support. Participants had received a living or deceased donor kidney transplant and were 6 months - 5 years post-surgery at the time of enrollment in the study. A total of 93 participants completed self-report measures and a semi-structured clinical interview via telephone that assessed each of the aforementioned dimensions with regard to a specified relationship. A subsample of 67 participants were married or involved in a committed dating relationship and responded to interview questions with their partner in mind; the remaining participants selected the person to whom they felt closest over the preceding 6 months (e.g., friend, sibling, parent). Structural equation modeling and linear regression were used to analyze the data. Results suggested that the distinct yet highly correlated dimensions reflected an underlying 'relationship quality' construct. Poorer relationship quality was associated with increased symptoms of depression, decreased feelings of well-being, and worse mental health-related quality of life for both the full sample and the subsample of participants in a romantic relationship. The path between relationship quality and depression remained significant for romantic relationship participants when global social support was included in the model, but global social support was more strongly associated with depression, well-being, and health-related quality of life for all participants. Relationship quality was not associated with adherence or graft function in this sample. However, interesting interaction effects were found, such that high conflict and lack of emotional intimacy were more strongly associated with poorer self-reported adherence in women. In addition, women who reported higher conflict in their relationship also endorsed increased depression, decreased well-being, and worse mental health-related functioning compared to men. These findings are consistent with previous research that has cited the importance of global social support for patients who have received a kidney transplant. The present study also provides novel evidence that other dimensions of relationship quality contribute to outcomes in this population. A comprehensive assessment of recipients' close relationships throughout the transplant process, particularly of conflict and emotional intimacy in women, would allow clinicians to recommend psychosocial interventions that could improve patient outcomes.

Indiana University-Purdue University Indianapolis (IUPUI) / Poor long-term kidney transplant outcomes are a significant problem in the U.S. Interventions must focus on preserving allograft function by managing modifiable risk factors. An instrument capable of identifying problems with post-kidney transplant self-management behaviors may enable the design and testing of self-management interventions. This study’s purpose was to test the psychometric properties of the new Kidney Transplant Self-Management Scale (KT–SM). The Zimmerman framework adapted for kidney transplant self-management guided the cross-sectional study. A total of 153 kidney recipients recruited from Facebook® completed the Self-Efficacy for Managing Chronic Disease (SEMCD), Patient Activation Measure (PAM), Kidney Transplant Questionnaire (KTQ), and KT–SM Scale instruments via a REDCap® survey. Most participants were female (65%), White (81.7%), and middle-aged (M = 46.7; SD = 12.4 years) with a history of dialysis (73%) and received a kidney transplant an average of 6.58 years previous (SD = 6.7). Exploratory factor analysis results supported the 16-item KT–SM Scale as a multidimensional scale with five domains with loadings ranging between .39 and .89: medication adherence, protecting kidney, cardiovascular risk reduction, ownership, and skin cancer prevention. Internal consistency reliability for the total scale (Cronbach’s α = .84) and five domains ranged from .71 to .83. The total and domains were positively correlated, ranging from r = .51 to .76, p = .01. Criterion-related validity was evidenced by significant correlations of KT–SM and domains with SEMCD (r =.22 to .53, p = .01), PAM (r = .31 to .52, p = .01), and the overall KTQ (r = .20 to .32, p = .01) except for one KT–SM domain: protecting kidney. Construct validity was evaluated using multivariate regression analysis. The linear combination of age, patient activation, and self-efficacy explained 45% of the variance in KT–SM behaviors; 47% of the variance in KTQ (measuring quality of life) was predicted by age, comorbidity, and self-efficacy. These findings provide beginning evidence of reliability and validity for the newly developed KT–SM scale. Instruments like this may provide a means to capture the self-management behaviors of the kidney transplant population, which is critical for future work on interventions.

No description available.

BK polyomavirus (BKV) is associated with urinary apparatus pathogenesis in kidney transplant recipient. Immune suppression triggers BKV reactivation that potentially causes polyomavirus associated nephropathy (PVAN), a major post-transplant problem causes graft rejection. Antiviral immunity plays the key role in limiting the viral replication but selection by the immune system or antivirals may cause the evolvement of escape variants with higher fitness. Mutation in VP1, the major capsid protein can allow BKV to escape neutralizing antibodies. In an attempt to detect co-infection and minor variants, BKV VP1 genomic region was amplified by PCR and analysed by deep sequencing from plasma samples of four kidney transplant recipients. BKV genotype I and IV was identified in patients and each patient was detected with one BKV genotype. Multiple point mutations and subsequent changes in amino acid were detected in majority, three out of four, of the patients.

No description available.

Bakgrund: Njuren är det mest donerade organet i Sverige och så många som 445 stycken transplantationer av njurar utfördes 2021. Som sjuksköterska är det viktigt att öka förståelsen kring patientens upplevelse för att främja trygghet och ett gott välbefinnande. Sjuksköterskan har en viktig roll i omvårdnaden i form av information och stöd.  Syfte: Syftet med litteraturstudien var att belysa patienters upplevelser av att vänta på en njurtransplantation. Metod: Det utfördes en litteraturöversikten med en kvalitativ ansats. Med den här metoden identifierades problemområdet som sammanställdes och sammanfattades med hjälp av redan tillgänglig forskning och kunskap för att fastställa kunskapsläget inom området.  Resultat: Det redovisades fem teman utifrån tio kvalitativa vetenskapliga artiklar som beskriver patientens upplevelse i väntan av en njurtransplantation. De fem teman som identifierades var: Att vara inskriven på väntelistan, en väntan utan tydligt slut, livet på paus, lycka och död samt önskan om stöd.  Slutsats: En njurtransplantation var nyckeln till ett nytt liv för människor som levde med en sviktande njure och behandlas med dialys. Många av patienterna som var med på väntelistan hade tappat hoppet och behövde mer information och stöd från vårdpersonalen för att hitta strategier och återfå hoppet för en fungerande vardag. / Background: The kidney is the most donated organ in Sweden and as many as 445 kidney transplants were performed in 2021. As a nurse it's important to improve the understanding of the patient's experience in order to promote security and a good sense of well-being. The nurse has an important role in nursing regarding information and support. Aim: The purpose of this literature study was to shed light on the patient's experience of waiting for a kidney transplant. Method: A literature review was carried out with a qualitative approach. This method identified the problem area, which compiled and summarized already available research and knowledge in order to determine the state of knowledge in the field. Results: Five themes were reported on ten qualitative articles that describe the patient's experience while waiting for a kidney transplant. The five themes were: To be on the waiting list, A wait without a clear ending, Life on pause, Happiness and death and The wish for support.  Conclusion: A kidney transplant was the key to a new life for people living with kidney failure and being treated with dialysis. Many of the patients who were on the waiting list had lost hope and needed more information and support from the healthcare staff to find strategies. Strategies were needed to regain hope and to have a functioning everyday life.

Bakgrund: Cirka 1 100 svenskar drabbas varje år av en njursjukdom och ungefär 4 000 personer behandlas med dialys i Sverige. Antalet patienter som behandlas med dialys och/eller njurtransplantation ökar kraftigt. Tiden före en njurtransplantation är krävande och personerna lever med svåra biverkningar av sjukdomen och behandlingarna. Njurtransplantation är en eftertraktad behandlingsform som följs av livslång behandling med immunsuppressiva läkemedel. En njursjukdom medför en förändrad livsvärld och livsrytm för personerna. Syfte: Syftet med detta examensarbete var att belysa personers upplevelser av livet efter en njurtransplantation. Metod: Metoden som användes var en litteraturöversikt med tio kvalitativa artiklar. Resultat: I resultatet framkom fyra huvudteman. Dessa var; positiva upplevelser av livet efter en njurtransplantation, negativa upplevelser av livet efter en njurtransplantation, personer som genomgått en njurtransplantations upplevelse av det sociala stödets betydelse, personer som genomgått en njurtransplantations upplevda behov och brister kring information. Konklusion: Examensarbetet visade att personer upplevde ökad livskvalitet och förbättrad hälsa efter njurtransplantationen men att det fanns en ständig närvaro av oro och rädsla inför framtiden. Information, utbildning och kommunikation var faktorer som påverkade personernas upplevelser. / Background: Around 1,100 Swedes suffer from a kidney disease every year and approximately 4,000 people are treated with dialysis in Sweden. The number of patients treated with dialysis and/or kidney transplantation is increasing sharply. The time before a kidney transplantation is demanding and the people live with severe side effects of the disease and the treatment. Kidney transplantation is a desirable form of treatment that is followed by life-long treatment with immunosuppressive drugs. A kidney disease may cause a changed world of life and rhythm of life for the persons. Aim: The aim of this bachelor’s essay was to highlight people’s experiences of life after a kidney transplantation. Method: The method used was a literature review with ten qualitative articles. Findings: Four main themes emerged in the results. These were; positive experiences of the time after a kidney transplantation, negative experiences of the time after a kidney transplantation, people who have gone through a kidney transplantations experience of the importance of social support, people who have gone through a transplantations experience of needs and lack of information. Conclusion: The bachelor’s essay showed that people experienced increased quality of life and improved health after the kidney transplantation but that there was a constant presence of worry and fear about the future. Information, education and communication were factors that influenced the people’s experiences.

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No description available.

INTRODUÇÃO: A avaliação da Qualidade de Vida tem se destacado de modo crescente em pesquisas clínicas de pacientes com transplante renal. O WHOQOLAbreviado é um dos instrumentos usados para avaliar a Qualidade de Vida em várias populações. O objetivo deste estudo foi avaliar e comparar a Qualidade de Vida nos pacientes transplantados renais submetidos à ampliação vesical e transplantados renais utilizando o WHOQOL-Abreviado e verificar a co-interferência de outros fatores sua Qualidade de Vida desses grupos. MÉTODOS: este é um estudo caso-controle e foi realizado na Unidade de Transplante Renal da Divisão de Clínica Urológica do Instituto Central da Faculdade de Medicina da Universidade de São Paulo, de julho a novembro de 2007. Foram incluídos no estudo todos os pacientes transplantados renais submetidos à Ampliação Vesical entre 1972 e 2004 com enxerto funcionante (Grupo Caso) e seus respectivos pares (Grupo Controle). Participaram 15 pacientes no Grupo Caso e 27 no Grupo Controle. Através do prontuário médico e de uma ficha de caracterização foram coletados os dados demográficos, sociais e econômicos. A Qualidade de Vida foi avaliada apenas uma vez durante a entrevista com a pesquisadora. RESULTADOS: Os grupos foram muito semelhantes entre si na maioria das variáveis analisadas. No Grupo Caso observou-se menor renda pessoal (p=0,013) e menor IMC (p=0,022). A avaliação da Qualidade de Vida foi semelhante em quase todos os domínios do WHOQOLAbreviado, a única diferença ocorreu no Domínio Relações Sociais, onde o Grupo Caso teve um escore menor que o Grupo Controle (p=0,058). Houve uma integração significativa entre o Domínio Relações Sociais e a faceta suporte (apoio) social (r=0,703; p=0,004). CONCLUSÃO: A Qualidade de Vida foi muito semelhante entre os dois grupos de transplantados renais. O Grupo Caso apresentou menor resultado no Domínio Relações Sociais, sendo que esse resultado parece estar diretamente ligado à particularidade da patologia urológica do grupo / The evaluation of health-related Quality of Life is fundamental when searching for better treatment in renal transplantation. The WHOQOL-Bref is used questionnaire to assessment for many population. The purpose of this study was evaluated and compared the Quality of Life of renal transplant patients with bladder augmentation using WHOQOL-Bref and check the co-interference of other factors their Quality of Life of these groups. METHODS: This is case-control study, performed in a Unit of Renal Transplant of the Division of Urology of the Central Institute of the Hospital of the Clinics of the College of Medicine of the University of São Paulo. Were included in the study all patients of the renal transplant with bladder augmentation between 1972 and 2004 with functioning graft (Case Group) and their peers (Control Group). Fifteen Case Group and 27 Control Group patients were enrolled. Through the medical records and a form of characterization data were collected demographic, social and economic. The Quality of Life was assessed once an interview with one of the authors. RESULTS: Both groups were very similar in most of the analyzed domains. In Case Group if it was observed lower personal income (p = 0,013) and lower BMI (p = 0,022). The assessment of Quality of Life was similar in almost all areas of WHOQOL-Bref, the only difference occurred in Social Relations Domains, where the Case Group if had a score lower than the Control Group (p=0,058). There was a significant integration between the Social Relations Domains facet support social (r = 0,703 and p = 0,004). CONCLUSION: The Quality of Life was very similar between the two groups of renal transplant. The Case Group presented result in lower Social Relations Domains, and that outcome appears to be directly connected to the peculiarity of urological pathology of the group