Tacrolimus and quality of life after kidney transplantation - a multicenter study

Kidney transplantation is currently the treatment of choice for end-stage renal disease. Although new immunosuppressive drugs have been introduced into clinical practice, the effect of such medication on quality of life (QoL) in transplant recipients is still unclear. The present study analyzes the impact of tacrolimus-based immunosuppression on QoL in a representative sample of adult kidney transplant recipients from Rio Grande do Sul, a Brazilian southern state. This was a cross-sectional multicenter study which used the SF-36 Health Survey for measuring QoL. The effect of tacrolimus on QoL was adjusted for possible confounders using multiple linear regression. A total of 272 patients (from 11 different centers) were evaluated, 48 of them were treated with tacrolimus. Transplant patients in use of tacrolimus presented significant higher scores in the physical component summary of SF-36 than non-users (49.1 +/- 8.3 vs. 46.1 +/- 8.7; p = 0.03), and such difference was noted in the physical functioning and general health subscales (81.5 +/- 17.1 and 74.7 +/- 21.8; 74.6 +/- 22.3 and 67.1 +/- 22.3 for users and non-users of tacrolimus, respectively, p < 0.05). The effect of tacrolimus remained significant after adjustment for age, gender, skin color and time since transplantation (coeff.: 2.83; 95% CI: 0.05-5.6, p = 0.045). The association between tacrolimus-based immunosuppression and better perception of physical functioning and general health for renal transplant patients represents a significant finding as it may influence therapeutical decisions and contribute to maximize kidney transplantation benefits.