نبذة مختصرة : An increasing number of patients are living with kidney transplants for longer periods of time due to improvements in transplant success rates. As a result, life after transplant has gained more attention. Unfortunately, health-related quality of life (HRQoL) in kidney transplant recipients is still lower compared to the general population. To improve this, it is important to identify factors that influence HRQoL. Therefore, the aim of this thesis is to identify new factors of HRQoL after a kidney transplant, with the goal of finding potential targets for interventions to improve HRQoL. We found that kidney transplant recipients often suffer from a high symptom burden, which seems to be a key factor limiting their HRQoL. We identified proton-pump inhibitor use, the microbiome, iron deficiency, poor sleep quality, hand dexterity, and muscle mass or strength as potential targets for improving HRQoL in kidney transplant recipients, based on cross-sectional observational studies. Rigorous longitudinal observational and intervention studies are needed to substantiate the evidence base and to explore whether interventions targeted towards the identified factors can improve HRQoL in this population. Furthermore, we showed that a lifestyle intervention consisting of supervised exercise therapy can enhance HRQoL in kidney transplant recipients, but sustaining these improvements remains a challenge that requires further investigation.
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