Rebollo P, Bobes J, González M P, Saiz P, Ortega F
Departamento de Medicina, Area de Psiquiatría de la Universidad de Oviedo.
Nefrologia. 2000 Mar-Apr;20(2):171-81.
The aim of this study was to investigate the sociodemographic and clinical variables which influence health-relate quality of life (HRQOL) of patients on renal replacement therapy (RRT). A cross-sectional study was carried out with a sample including all patients on hemodialysis (n = 170) and transplant patients (n = 210) of our region. The HRQOL assessment instruments used in this study were: the Spanish versions of the sickness impact profile (SIP) and the SF-36 health survey (SF-36). Sociodemographic and clinical data (including age at start of RRT, age at the interview, gender, hospital, socioeconomic level, educational level, living conditions, inclusion in transplant waiting list, renal disease diagnosis, time in any RRT, hemoglobin, hematocrit, serum urea, creatinine, proteins and albumin, hospital admissions and length of hospital stay during last year), a comorbidity index and the Karnofsky performance scale score step. To investigate which studied variables had independent influence over the HRQOL measures, logistic regression method was employed in the case of the SF-36, and multiple regression, in the case of the SIP. A model was adjusted step by step in each RRT method (hemodialysis and transplantation) for each dimension of the PCE (physical dimension, psychosocial dimension and total score), and for each component summary score of the SF-36 (physical and mental component summary). In patients on hemodialysis, variables associated with better HRQOL were: higher age, female gender, higher educational level, and better functional status; and variables associated with worse HRQOL were: higher number of hospital admissions, and higher comorbidity index. In transplant patients, variables associated with better HRQOL were: higher age and higher functional status; and variables associated with worse HRQOL were: longer time on dialysis before transplant, longer time with functioning transplant, and higher comorbidity index. Despite the independent influence on the HRQOL demonstrated for some of the studied variables, it seems that HRQOL assessment instruments scores may mainly depend on other non-studied variables, and it may be that these instruments evaluate other aspects of the patients which have not been taken into account until now.
本研究旨在调查影响接受肾脏替代治疗（RRT）患者健康相关生活质量（HRQOL）的社会人口统计学和临床变量。对本地区所有血液透析患者（n = 170）和移植患者（n = 210）进行了一项横断面研究。本研究中使用的HRQOL评估工具为：疾病影响量表（SIP）和SF - 36健康调查（SF - 36）的西班牙语版本。社会人口统计学和临床数据（包括开始RRT的年龄、访谈时的年龄、性别、医院、社会经济水平、教育程度、生活条件、是否列入移植等待名单、肾脏疾病诊断、接受任何RRT的时间、血红蛋白、血细胞比容、血清尿素、肌酐、蛋白质和白蛋白、住院次数以及去年的住院时间）、合并症指数和卡诺夫斯基功能量表评分步骤。为了研究哪些研究变量对HRQOL测量有独立影响，对于SF - 36采用逻辑回归方法，对于SIP采用多元回归方法。针对每种RRT方法（血液透析和移植），针对PCE的每个维度（身体维度、心理社会维度和总分）以及SF - 36的每个成分汇总评分（身体和心理成分汇总）逐步调整模型。在血液透析患者中，与更好的HRQOL相关的变量为：年龄较大、女性、教育程度较高和功能状态较好；与较差的HRQOL相关的变量为：住院次数较多和合并症指数较高。在移植患者中，与更好的HRQOL相关的变量为：年龄较大和功能状态较高；与较差的HRQOL相关的变量为：移植前透析时间较长、移植功能正常时间较长和合并症指数较高。尽管某些研究变量对HRQOL有独立影响，但HRQOL评估工具的评分似乎可能主要取决于其他未研究的变量，并且可能是这些工具评估了患者目前尚未考虑到的其他方面。
