Transcultural adaptation and validation of the Mexican version of the kidney disease questionnaire KDQOL-SF36 version 1.3.

PURPOSE: To translate the Kidney Disease Quality of Life Short Form 36 (KDQOL-SF36) v1.3 questionnaire into the Spanish language, adapt it culturally, and validate it in the Mexican population. METHODS: The translation and transcultural adaptation were performed according to the recommendations of RAND Health (translation/pilot test/back-translation). We used coefficient alpha to determine the internal consistency, intra- and interobserver intraclass correlation coefficients (ICCs) to determine the test-retest reliability, and Pearson correlation coefficients to confirm the construct validity. RESULTS: The questionnaires were applied to 194 Mexican on haemodialysis. In total, 37.6 % lived in the northern region of Mexico, 28.9 % lived in the southern region, and 33.5 % lived in the central region. The average age was 54 ± 16 years, and 54.6 % were male. The intra- and interobserver ICCs were ≥0.7 for most dimensions evaluated (range 0.5-0.9). The internal consistency was acceptable, with coefficient alpha values ≥0.7 for 12 of the 18 dimensions (range 0.4-0.9). The construct validity was acceptable, especially in the generic component SF36, with correlation coefficients >0.5 for most dimensions. CONCLUSIONS: Psychometric testing indicated that the Mexican version of the KDQOL-SF36 provided valid and reliable scores that were similar to the results obtained with the original English version.

Clinical, Dialytic, and Laboratory Factors Associated With Poor Health-Related Quality of Life in Mexican Patients on Hemodialysis.

BACKGROUND: End-stage renal disease and its treatment have a negative impact on the quality of life of patients. OBJECTIVE: To determine the clinical, dialytic, and laboratory factors associated with poor health-related quality of life in Mexican patients on hemodialysis. METHODS: A multicenter, cross-sectional study. The KDQOL-SF36 v1.3 questionnaire was applied to patients with end-stage renal disease on hemodialysis in different regions of Mexico. Patients were classified according to their overall score on the questionnaire: poor health-related quality of life (overall score below the median) or good health-related quality of life (overall score above the median). Clinical, dialytic, and laboratory variables associated with poor health-related quality of life were analyzed using linear correlation and multivariate logistic regression. RESULTS: We included 194 adult patients with a median age of 55 (45-64) years. The diagnosis of poor health-related quality of life was present in 47.4% of patients. A poor correlation was found between the clinical, dialytic, and biochemical parameters and the health-related quality of life score (range of correlations r = -0.4 to 0.2). Serum albumin level showed the highest number of weak, statistically significant correlations. Factors associated with poor health-related quality of life in the multivariate analysis were: time spent on hemodialysis (OR = 1.02; 95% CI; 1.00-1.04; p = 0.02), use of a venous catheter (OR = 3.2; 95% CI: 1.36-7.75; p = 0.01), and serum albumin < 4 g/dl (OR = 3.55; 95% CI: 1.44-8.74; p < 0.01). CONCLUSIONS: Poor health-related quality of life was common in Mexican patients undergoing hemodialysis. No strong correlation was found between the clinical, dialytic, or laboratory factors with health-related quality of life. Factors associated with poor health-related quality of life were: time on hemodialysis, use of a venous catheter, and serum albumin level < 4 g/dl.

Screening for tuberculosis in the study of the living renal donor in a developing country.

Given the high prevalence of tuberculosis (Tb) in the Mexican population, a strict program to detect Tb in the potential donor is required. Chest x-ray, excretory urogram, urinalysis with microscopic exam of the sediment, urine cultures for M. tuberculosis, and tuberculin skin test (TST) with PPD-RT23 performed for evaluation of 222 living donors were reviewed. Isoniazid prophylaxis before kidney donation was gathered. Donors and recipients were followed up for a minimum of 2 years. According to the TST result, 36.8% of the donors had latent tuberculosis; however, all other studies were normal or negative in all of them. Use of isoniazid prophylaxis in TST-positive donors made no difference in risk of transmission of tuberculosis to the recipient or development of tuberculosis among the donors. Normal chest x-ray and excretory urogram, along with a negative microscopic examination of the urine, safely exclude tuberculosis transmission to recipients.