Germin-Petrović Daniela, Mesaros-Devcić Iva, Lesac Ana, Mandić Marin, Soldatić Marin, Vezmar Dragana, Petrić Daniela, Vujicić Bozidar, Basić-Jukić Nikolina, Racki Sanjin
Istrian Health Centers, Umag Dialysis Center, Umag, Croatia.
Coll Antropol. 2011 Sep;35(3):687-93.
Health-related quality of life (HRQoL) among hemodialysis (HD) patients recently became a nephrologist's focus of interest. HRQoL is an important predictor of outcome in HD patients and need to be regularly assessed. The aim of the present study was to compare the HRQoL of chronic HD patients with general population and to analyze influencing sociodemographic and clinical factors. We included 255 prevalent HD patients from four dialysis centers. HRQoL was measured with The Medical Outcomes Study Short Form 36 Health Survey Questionnaire (SF-36). This data were compared with control group (N = 132) from the general Croatian population. Comparisons of SF-36 scale scores of HD patients regarding demographic and clinical factors (age, gender, education level, dialysis vintage and diabetes) were also performed and analyzed with a multivariate regression analysis. HRQoL in prevalent HD patients was relatively low (mean Physical Component Summary, PCS = 33.7, mean Mental Component Summary, MCS = 43.0) and was lower compared to the control group from the general population in all HRQoL domains, PCS and MCS scores. Almost 53% of the HD patients had the critical score PCS < 43 + MCS < 51 as the predictor of death and hospitalization. Better HRQoL was revealed in the patients < 65 years old, males, patients with higher educational level and in the patients on maintenance HD less than one year. Age was the only statistically significant predictor of PCS and MCS. Developments of HD technology, treatment of comorbidities, continuous patients' education, social and psychological support and use of other renal replacement modalities, especially kidney transplantation, may improve the HRQoL in these patients.
血液透析(HD)患者的健康相关生活质量(HRQoL)近来成为肾病学家关注的焦点。HRQoL是HD患者预后的重要预测指标,需要定期评估。本研究的目的是比较慢性HD患者与普通人群的HRQoL,并分析影响其的社会人口学和临床因素。我们纳入了来自四个透析中心的255例维持性HD患者。使用医学结局研究简明健康调查问卷(SF-36)对HRQoL进行测量。将这些数据与克罗地亚普通人群的对照组(N = 132)进行比较。还对HD患者SF-36量表得分在人口统计学和临床因素(年龄、性别、教育水平、透析龄和糖尿病)方面进行了比较,并通过多变量回归分析进行分析。维持性HD患者的HRQoL相对较低(平均生理健康评分,PCS = 33.7,平均心理健康评分,MCS = 43.0),在所有HRQoL领域、PCS和MCS得分方面均低于普通人群的对照组。近53%的HD患者临界评分PCS < 43 + MCS < 51,作为死亡和住院的预测指标。年龄<65岁的患者、男性、教育水平较高的患者以及维持性HD时间少于一年的患者的HRQoL更好。年龄是PCS和MCS唯一具有统计学意义的预测指标。HD技术的发展、合并症的治疗、持续的患者教育、社会和心理支持以及其他肾脏替代方式的使用,尤其是肾移植,可能会改善这些患者的HRQoL。