{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T20:59:07Z","timestamp":1781816347146,"version":"3.54.5"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Impaired kidney function in the non\u2010transplant chronic kidney disease (CKD) population has been shown to negatively affect patients\u2019 health related quality of life (HRQOL). The relationship between posttransplant graft function, as measured by estimated glomerular filtration rate (eGFR), and patient\u2010reported outcomes (PRO) remains poorly understood. This study evaluates the associations between eGFR and PRO in kidney transplant recipients to inform clinical strategies aimed at optimizing both physical and psychological well\u2010being.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Longitudinal data were collected using previously\u2010described procedures and a multi\u2010survey PRO battery. Logistic regression models evaluated relationships, at the last follow\u2010up point, between eGFR strata, time posttransplant, age at PRO, whether there had been a previous kidney transplant or the donor was deceased or living, and the likelihood of physical or mental HRQOL being substantive low and of symptoms of depression or anxiety being reported. Parallel multivariable mixed effects models, that included all longitudinal data points for each participant, examined relationships between eGFR and continuous PRO scores and their temporal trajectories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 2116 adult kidney transplant recipients and over 9500 unique multi\u2010survey observation points over a 19\u2010year period. After adjusting for age (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), donor type, time posttransplant, and prior kidney transplantation, there was a statistically significant association between eGFR\/CKD strata and the likelihood of physical HRQOL being substantively low (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) at the last PRO assessment. CKD stage 4 or 5 was independently associated with a 1.5 times increased likelihood of reporting symptoms of depression (OR: 1.50; 95% CI 1.16, 1.95) and anxiety (OR = 1.48; 95%CI: 1.14, 1.92) compared to those with eGFR \u2265 60\u00a0mL\/min\/1.73m\n                      <jats:sup>2<\/jats:sup>\n                      . Longitudinal analyses comprising all data points demonstrated that increased eGFR was associated with better physical and mental HRQOL and reduced symptoms of depression and anxiety.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Impaired graft function is significantly associated with decreased physical HRQOL and increased symptoms of depression and anxiety in kidney transplant recipients. These findings underscore the importance of close monitoring and early interventions targeting physical and psychological well\u2010being as graft function declines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70500","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T18:20:08Z","timestamp":1772994008000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of Posttransplant Kidney Function With Patient Reported Outcomes: A Single Center's Experience Over Nearly Two Decades"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3021-4024","authenticated-orcid":false,"given":"Peter","family":"Thorne","sequence":"first","affiliation":[{"name":"Division of Nephrology and Hypertension University of Minnesota Medical Center  Minneapolis Minnesota USA"},{"name":"Division of Nephrology and Hypertension Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A.","family":"Binari","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott A.","family":"Rega","sequence":"additional","affiliation":[{"name":"Vanderbilt Transplant Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guneet","family":"Kochar","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Metrolina Nephrology Associates, P.A.  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel C.","family":"Forbes","sequence":"additional","affiliation":[{"name":"Division of Kidney and Pancreas Transplantation Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Wright","family":"Pinson","sequence":"additional","affiliation":[{"name":"Vanderbilt Transplant Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene D.","family":"Feurer","sequence":"additional","affiliation":[{"name":"Vanderbilt Transplant Center  Nashville Tennessee USA"},{"name":"Departments of Surgery and Biostatistics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0576-6756","authenticated-orcid":false,"given":"Beatrice P.","family":"Concepcion","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Section of Nephrology University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199912023412303"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2004.09.019"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524\u20104733.2007.00193.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.15537\/smj.2018.7.21352"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000518668"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2007.03.088"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010023\u201028150\u2010w"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11255\u2010022\u201003375\u20102"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/152692480701700207"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010150\u20109\u2010200905050\u201000006"},{"key":"e_1_2_11_12_1","volume-title":"SF\u201036\u00ae Health Survey Manual and Interpretation Guide","author":"Ware J. 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