Lee Amanda J, Morgan Christopher Ll, Conway Pete, Currie Craig J
Cardiff Research Consortium, University Hospital of Wales, Cardiff, UK.
Curr Med Res Opin. 2005 Nov;21(11):1777-83. doi: 10.1185/030079905X65277.
The objective of this study was to assess the health related quality of life (HRQOL) in patients with kidney failure who had received renal transplants compared to those receiving haemodialysis, peritoneal dialysis or were waiting to start dialysis.
The study was conducted at the University Hospital of Wales, Cardiff. HRQOL was measured using the EQ-5D, SF-36 and the Kidney Disease Quality of life questionnaire (KDQOL). Patients with kidney failure were identified from the renal unit departmental database and were surveyed by postal questionnaire or during their treatment.
Of 1251 people surveyed, 416 valid returns were received, a response rate of 33%. For renal transplant patients the mean EQ-5Dindex was 0.712 (SD 0.272), significantly higher than those in the other treatment groups (haemodialysis mean = 0.443 (SD 317), p < 0.001; peritoneal dialysis mean = 0.569 (SD 329), p < 0.001). This difference remained after controlling for age and co-morbidity. With the exception of pain, the SF-36 showed significantly higher scores across all domains for transplant patients compared to both dialysis groups. From the KDQOL there were significantly lower scores compared with the transplant patients for both groups of dialysis patients for the effects and burden of kidney disease and general symptoms and problems. However, overall health scores were significantly higher for dialysis patients compared with transplant patients.
Kidney failure has a high cost in terms of health related quality of life. There was a large difference between patients who have received a functioning graft following kidney transplant versus the alternative methods of renal replacement therapy, that is, peritoneal dialysis and haemodialysis. Kidney transplant should be the treatment of choice, and every effort should be made to increase the availability of kidneys for transplantation.
本研究的目的是评估接受肾移植的肾衰竭患者与接受血液透析、腹膜透析或等待开始透析的患者相比，其健康相关生活质量（HRQOL）。
该研究在威尔士大学医院（位于加的夫）进行。使用欧洲五维度健康量表（EQ-5D）、36项简短健康调查量表（SF-36）和肾脏病生活质量问卷（KDQOL）来测量健康相关生活质量。从肾脏科部门数据库中识别出肾衰竭患者，并通过邮寄问卷或在其治疗期间进行调查。
在1251名接受调查的人中，收到了416份有效回复，回复率为33%。肾移植患者的平均EQ-5D指数为0.712（标准差0.272），显著高于其他治疗组（血液透析组平均为0.443（标准差0.317），p<0.001；腹膜透析组平均为0.569（标准差0.329），p<0.001）。在控制年龄和合并症后，这种差异仍然存在。除疼痛外，与两个透析组相比，移植患者在SF-36所有领域的得分均显著更高。从KDQOL来看，两组透析患者在肾病的影响和负担以及一般症状和问题方面的得分与移植患者相比显著更低。然而，透析患者的总体健康得分与移植患者相比显著更高。
肾衰竭在健康相关生活质量方面代价高昂。接受肾脏移植后获得功能正常移植物的患者与肾脏替代治疗的替代方法（即腹膜透析和血液透析）之间存在很大差异。肾移植应是首选治疗方法，应尽一切努力增加可用于移植的肾脏数量。
