Presentation (CTI)

OBJECTIVES: Kidney transplant (KT) provides several important advantages over haemodialysis (HD). However, only 7 out of the 46 countries in Sub-Saharan Africa offer KT services. This study aimed to assess and compare health-related quality of life (HRQOL) by measuring and valuing utilities among HD and KT patients in Kenya.
METHODS: A cross-sectional study involving ESKD patients was conducted from April to October 2024 in Kenya’s largest teaching and referral hospital i.e., Kenyatta National Hospital (KNH) in Nairobi and Othaya sites. In the absence of Kenya value sets, utility score was estimated using Ethiopian and Ugandan value sets. The difference between utility scores derived from the two value sets were compared using Wilcoxon-signed rank test while the difference between utility score of HD and KT patients was compared using Mann Whitney U test. Tobit regression was employed to examine factors affecting utility.
RESULTS: A total of 69 HD and 50 KT patients were interviewed. The mean (SD) EQ-5D-5L utility score of HD patients was 0.681 (0.386) and 0.542 (0.485) based on the Ethiopian and Ugandan value sets, respectively. In comparison, significantly higher scores were observed among KT patients with the mean (SD) values for the two values sets of 0.920 (0.163) and 0.868 (0.231), respectively. Utility scores derived from the two value sets were significantly different (p < 0.001). For both modalities, the most affected domain was anxiety/ depression while the least affected domain was self-care.
CONCLUSIONS: The results demonstrate a significantly higher HRQOL among KT compared to HD patients. These results were consistent using across both the EQ-5D-5L and the EQ-VAS instruments and the Ethiopian and Ugandan value sets. The study underscores the critical need to expand access to KT for ESKD patients for better quality of life. Moreover, the study underscores the critical need for Kenya-specific EQ-5D value set.