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每日短时血液透析对中国患者贫血及生活质量的影响。

The impact of short daily hemodialysis on anemia and the quality of life in Chinese patients.

机构信息

Qilu Hospital, Shandong University, Department of Nephrology, Jinan, China.

出版信息

Braz J Med Biol Res. 2013 Jul;46(7):629-33. doi: 10.1590/1414-431X20132832. Epub 2013 Aug 9.

Abstract

Anemia is a frequent complication in hemodialysis patients. Compared to conventional hemodialysis (CHD), short daily hemodialysis (sDHD) has been reported to be effective in many countries except China. The aim of the present study was to determine whether sDHD could improve anemia and quality of life (QOL) for Chinese outpatients with end-stage renal disease. Twenty-seven patients (16 males/11 females) were converted from CHD to sDHD. All laboratory values were measured before conversion (baseline), at 3 months after conversion (sDHD1), and at 6 months after conversion (sDHD2). The patient's QOL was evaluated at baseline and 6 months after conversion using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36). Hemoglobin concentration increased significantly from 107.4 ± 7.9 g/L at baseline to 114.4 ± 6.8 g/L (P<0.05) at sDHD1, and 118.3±8.4 g/L (P<0.001) at sDHD2 (Student paired t-test). However, the dose requirement for erythropoietin decreased from 6847.8 ± 1057.3 U/week at baseline to 5869.6±1094.6 U/week (P<0.05) at sDHD2. Weekly stdKt/V increased significantly from 2.05±0.13 at baseline to 2.73±0.20 (P<0.001) at sDHD1, and 2.84±0.26 (P<0.001) at sDHD2. C-reactive protein decreased from baseline to sDHD1 and sDHD2, but without statistically significant differences. Physical and mental health survey scores increased in the 6 months following conversion to sDHD. sDHD may increase hemoglobin levels, decrease exogenous erythropoietin dose requirements, and improve QOL in Chinese hemodialysis patients compared to CHD. A possible mechanism for improvement of clinical outcomes may be optimized management of uremia associated with the higher efficiency of sDHD.

摘要

贫血是血液透析患者的常见并发症。与常规血液透析(CHD)相比,短时间血液透析(sDHD)已在许多国家报道有效,除中国外。本研究旨在确定 sDHD 是否能改善中国终末期肾病门诊患者的贫血和生活质量(QOL)。27 例患者(16 例男性/11 例女性)从 CHD 转换为 sDHD。所有实验室值均在转换前(基线)、转换后 3 个月(sDHD1)和转换后 6 个月(sDHD2)进行测量。使用医疗结局研究 36 项简明健康调查问卷(SF-36)在基线和转换后 6 个月评估患者的 QOL。血红蛋白浓度从基线时的 107.4±7.9 g/L 显著升高至 sDHD1 时的 114.4±6.8 g/L(P<0.05)和 sDHD2 时的 118.3±8.4 g/L(P<0.001)(学生配对 t 检验)。然而,促红细胞生成素的剂量需求从基线时的 6847.8±1057.3 U/周降至 sDHD2 时的 5869.6±1094.6 U/周(P<0.05)。每周标准化 Kt/V 从基线时的 2.05±0.13 显著升高至 sDHD1 时的 2.73±0.20(P<0.001)和 sDHD2 时的 2.84±0.26(P<0.001)。C 反应蛋白从基线下降至 sDHD1 和 sDHD2,但无统计学意义。转换为 sDHD 后 6 个月,生理和心理健康调查评分增加。与 CHD 相比,sDHD 可能增加血红蛋白水平,降低外源性促红细胞生成素剂量需求,并改善中国血液透析患者的 QOL。临床结局改善的可能机制是通过 sDHD 更高的效率优化尿毒症的管理。

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