Dataset Information

Discrepancy between self-perceived mycophenolic acid-associated diarrhea and stool water content after kidney transplantation.

ABSTRACT:

Background

Diarrhea is a well-known side effect of mycophenolic acid (MPA) use in kidney transplant recipients (KTRs). It is unknown whether self-reported diarrhea using the Modified Transplant Symptom Occurrence and Symptom Distress Scale (MTSOSD-59R) corresponds to stool water content and how both relate to MPA usage.

Methods

MTSOSD-59R questionnaires filled out by 700 KTRs from the TransplantLines Biobank and Cohort Study (NCT03272841) were analyzed and compared with stool water content. Stool samples (N = 345) were freeze-dried, and a water content ≥80% was considered diarrhea.

Results

Self-perceived diarrhea was reported by 46%, while stool water content ≥80% was present in 23% of KTRs. MPA use was not associated with self-perceived diarrhea (odds ratio(OR) 1.32; 95% confidence interval(CI), 0.87-1.99, p = .2), while it was associated with stool water content ≥80% (OR 2.88; 95%CI, 1.41-5.89, p = .004), independent of potential confounders. Adjustment for prior MPA discontinuation because of severe diarrhea, uncovered an association between MPA use and self-perceived diarrhea (OR 1.80; 95%CI, 1.13-2.89, p = .01).

Conclusions

These results suggest that reporting bias could add to the discrepancy between both methods for diarrhea assessment. We recommend use of objective biomarkers or more extensive questionnaires which assess information on stool frequency and stool consistency, to investigate post-transplantation diarrhea.

SUBMITTER: Douwes RM

PROVIDER: S-EPMC8365659 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ObjectiveThe purpose of this study was to examine the difference between self-reported hearing status and hearing impairment assessed using conventional audiometry. The associated factors were examined when a concordance between self-reported hearing and audiometric measures was lacking.MethodsIn total, 19,642 individuals ?20 years of age who participated in the Korea National Health and Nutrition Examination Surveys conducted from 2009 through 2012 were enrolled. Pure-tone hearing threshold audiometry (PTA) was measured and classified into three levels: <25 dB (normal hearing); ?25 dB <40 dB (mild hearing impairment); and ?40 dB (moderate-to-severe hearing impairment). The self-reported hearing loss was categorized into 3 categories. The participants were categorized into three groups: the concordance (matched between self-reported hearing loss and audiometric PTA), overestimation (higher self-reported hearing loss compared to audiometric PTA), and underestimation groups (lower self-reported hearing loss compared to audiometric PTA). The associations of age, sex, education level, stress level, anxiety/depression, tympanic membrane (TM) status, hearing aid use, and tinnitus with the discrepancy between the hearing self-reported hearing loss and audiometric pure tone threshold results were analyzed using multinomial logistic regression analysis with complex sampling.ResultsOverall, 80.1%, 7.1%, and 12.8% of the participants were assigned to the concordance, overestimation, and underestimation groups, respectively. Older age (adjusted odds ratios [AORs] = 1.28 [95% confidence interval = 1.19-1.37] and 2.80 [2.62-2.99] for the overestimation and the underestimation groups, respectively), abnormal TM (2.17 [1.46-3.23] and 1.59 [1.17-2.15]), and tinnitus (2.44 [2.10-2.83] and 1.61 [1.38-1.87]) were positively correlated with both the overestimation and underestimation groups. Compared with specialized workers, service workers, manual workers, and the unemployed were more likely to be in the overestimation group (1.48 [1.11-1.98], 1.39 [1.04-1.86], and 1.50 [1.18-1.90], respectively), and service workers were more likely to be in the underestimation group (AOR = 1.42 [1.01-1.99]). Higher education level (0.77 [0.59-1.01] and 0.43 [0.33-0.57]) and hearing aid use (0.36 [0.17-0.77] and 0.23 [0.13-0.43]) were negatively associated with being in the underestimation group (0.43 [0.37-0.50]). Compared with males, females were less likely to be assigned to the underestimation group (0.43 [0.37-0.50]). Stress (1.98 [1.32-2.98]) and anxiety/depression (1.30 [1.06-1.59]) were associated with overestimation group.ConclusionOlder age, lower education level, occupation, abnormal TM, non-hearing aid use, and tinnitus were related to both overestimation and underestimation groups. Male gender was related to underestimation, and stress and anxiety/depression were correlated with overestimation group. An understanding of these factors associated with the self-reported hearing loss will be instrumental to identifying and managing hearing-impaired individuals.