Influence of spirituality on renal function of kidney transplant patients

Headnote

Keywords

Spirituality; Kidney transplantation; Chronic disease; Religion; Religion and medicine

Descritores

Espiritualidade; Transplante de rim; Doença crónica; Religiăo; Religiăo e medicina

Submitted

August 8, 2017

Accepted

October 24, 2017

Abstract

Objective: To evaluate influence of spirituality on renal function of kidney transplant patients.

Methods: This cross-sectional study included 81 kidney transplant patients who had undergone transplantation between 30 and 60 months previously. Patients were followed up for 12 months. The analysis was carried out in a large public hospital in the countryside of Sao Paulo, Brazil. Based on the Duke University Religion Index-religiosity and spirituality scale, we divided patients into two groups (spiritualized [n=52] and less spiritualized [n=29]), considering the median spirituality. For statistical analysis, we used inductive tests and analysis with linear mixed models, with a level of significance of 5% (p<0.05).

Results: Clinical characteristics, immunosuppression, social support, adherence to drug therapy, quality of life, and depression did not differ between groups. Renal function after 12 months was significantly higher in the spiritualized group from 9 months on. After 12 months, the percentage of patients with creatinine clearance higher than 60 ml/min was 61.5% in the spiritualized group and 34.5% in the less spiritualized group (p=0.02). Multivariate analysis showed that the less spiritualized group had a 4.7 times greater risk [1.4 - 16.8] for worsening in renal function (p=0.01).

Conclusion: More spiritualized patients had better renal function after 1 year of transplantation. This result was independent of clinical features, social support, and adherence to immunosuppressive therapy. A holistic approach in health with emphasis on spirituality is encouraged.

Resumo

Objetivo: Avaliar a influencia da espiritualidade na funçao renal de pacientes transplantados renais.

Métodos: Estudo transversal, conduzido em um hospital de clínicas, público e de grande porte, situado no interior do Estado de Sao Paulo, Brasil, que incluiu 81 pacientes transplantados renais, entre 30 dias e 60 meses de pós-transplante, seguidos por 12 meses. Com base na Escala de Religiosidade de DUREL os pacientes foram divididos em dois grupos considerando-se a mediana da espiritualidade, sendo estes o grupo espiritualizado (n=52) e o menos espiritualizado (n=29). Para a análise estatística foram utilizados testes indutivos e a análise de modelos lineares mistos, com nivel de significancia de 5% (p<0,05).

Resultados: As características clínicas, de imunossupressao, apoio social,...