Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, NTNU , Trondheim , Norway .
Ren Fail. 2014 Feb;36(1):9-16. doi: 10.3109/0886022X.2013.830206. Epub 2013 Sep 13.
For the majority of the older patients in dialysis, the treatment will be lifelong. Thus, quality of life (QoL) is a crucial outcome. Our aim was to assess the QoL of older Norwegian dialysis patients and to investigate the impact of early (estimated glomerular filtration rate, eGFR ≥10 mL/min) versus late (eGFR <10 mL/min) start in dialysis, comorbidity, nutritional status and physical capacity.
A self-report questionnaire including SF-36 (QoL) and the Subjective Global Assessment (SGA; nutritional status) was mailed to all patients (n = 320) ≥75 years registered in the Norwegian Renal Registry (NRR) as being in dialysis by September 2009. Reply was received from 233 patients (73%). Medical data including comorbidities and eGFR at dialysis start (obtained for 194 patients) were retrieved from the NRR. Functional capacity was determined from the SGA.
Compared to reports from younger dialysis patients, our patients scored poorer on all SF-36 subscales. Early start in dialysis was registered for 52 patients, 142 patients started late, 51.4% were well nourished (SGA A), 32.3% moderately malnourished (SGA B) and 16.4% were severely malnourished (SGA C). No significant association between any SF-36 scores and early versus late start, nutritional status or comorbidity was found. Better physical function was significantly associated with better scores on all SF-36 scales.
Our results indicate that physical function is important to all QoL aspects. Increased focus on physical rehabilitation seems pertinent. Early start of dialysis treatment was not associated with better long term QoL scores.
对于大多数接受透析治疗的老年患者来说，治疗将是终身的。因此，生活质量（QoL）是一个关键的结果。我们的目的是评估挪威老年透析患者的生活质量，并探讨早期（估计肾小球滤过率，eGFR≥10mL/min）与晚期（eGFR＜10mL/min）开始透析、合并症、营养状况和身体能力对生活质量的影响。
我们向所有在 2009 年 9 月前在挪威肾脏登记处（NRR）登记的年龄≥75 岁、正在接受透析治疗的患者（n=320）邮寄了一份包括 SF-36（生活质量）和主观整体评估（SGA；营养状况）在内的自我报告问卷。收到了 233 名患者（73%）的回复。从 NRR 中检索到包括合并症和透析开始时 eGFR 在内的医疗数据（194 名患者获得）。功能能力是根据 SGA 确定的。
与年轻透析患者的报告相比，我们的患者在所有 SF-36 子量表上的评分都较差。52 名患者早期开始透析，142 名患者晚期开始透析，51.4%营养良好（SGA A），32.3%中度营养不良（SGA B），16.4%严重营养不良（SGA C）。SF-36 评分的任何指标与早期与晚期开始、营养状况或合并症之间均无显著相关性。身体功能较好与所有 SF-36 量表的评分较好显著相关。
我们的结果表明，身体功能对所有生活质量方面都很重要。增加对身体康复的关注似乎是恰当的。早期开始透析治疗与长期生活质量评分的改善无关。
