Nourbala M-H, Hollisaaz M-T, Nasiri M, Bahaeloo-Horeh S, Najafi M, Araghizadeh H, Rezaie Y, Lak M
Nephrology/Urology Research Center (NURC), Baqiyatallah Medical Sciences University, Tehran, Iran.
Transplant Proc. 2007 May;39(4):1126-9. doi: 10.1016/j.transproceed.2007.03.004.
Chronic pain is prevalent in end-stage renal disease patients undergoing chronic hemodialysis. We do not fully know the intensity of chronic pain experienced by kidney recipients in comparison to those on chronic hemodialysis and healthy controls. Moreover, the effect of chronic pain on kidney recipients' health-related quality of life (HRQoL) is yet to be comprehensively addressed. We designed this study to find an answer to these questions.
In this case control study, we studied 205 kidney recipients, 69 hemodialysis patients, and 100 healthy controls, who were matched for age, sex, monthly family income, and educational level. The patients were evaluated for the intensity of chronic pain by Visual Analogue Scale (VAS). HRQoL was measured with Short Form 36 (SF-36) in the kidney recipients. Chronic pain intensity was compared in the study groups, and in the kidney recipients the correlation between SF-36 subscores and severity of pain was assessed.
Severity of pain in the kidney recipients was lower than the hemodialysis patients, but more than the healthy controls (P=.001). The VAS pain score negatively correlated with the scores of SF- 36 total (r=-.329, P=01), mental health (r=-.190, P=07), physical health (r=-.275, P=.001), physical function (r=-.339, P=.001), role limitation due to physical problems (r=-.478, P=.001), role limitation due to emotional problems (r=-.326, P=.001), and bodily pain (r=-.894, P=.001).
The intensity of chronic pain experienced by the kidney recipients is less than that experienced by patients under chronic hemodialysis, but higher than healthy subjects. Focusing on chronic pain as a cause of post-renal transplantation morbidity is expected to improve post-renal transplantation quality of life.
慢性疼痛在接受慢性血液透析的终末期肾病患者中普遍存在。与接受慢性血液透析的患者及健康对照相比，我们尚不完全了解肾移植受者所经历的慢性疼痛强度。此外，慢性疼痛对肾移植受者健康相关生活质量（HRQoL）的影响尚未得到全面探讨。我们设计了本研究以回答这些问题。
在这项病例对照研究中，我们研究了205名肾移植受者、69名血液透析患者和100名健康对照，他们在年龄、性别、月家庭收入和教育水平方面相匹配。通过视觉模拟量表（VAS）评估患者的慢性疼痛强度。使用简短健康调查问卷36项版本（SF-36）对肾移植受者的HRQoL进行测量。比较各研究组的慢性疼痛强度，并评估肾移植受者中SF-36子量表得分与疼痛严重程度之间的相关性。
肾移植受者的疼痛严重程度低于血液透析患者，但高于健康对照（P = 0.001）。VAS疼痛评分与SF-36总分（r = -0.329，P = 0.01）、心理健康（r = -0.190，P = 0.07）、身体健康（r = -0.275，P = 0.001）、身体功能（r = -0.339，P = 0.001）、因身体问题导致的角色限制（r = -0.478，P = 0.001）、因情绪问题导致的角色限制（r = -0.326，P = 0.001）以及身体疼痛（r = -0.894，P = 0.001）呈负相关。
肾移植受者所经历的慢性疼痛强度低于接受慢性血液透析的患者，但高于健康受试者。将慢性疼痛作为肾移植后发病的一个原因加以关注，有望改善肾移植后的生活质量。
