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肾移植患者及慢性肾脏病3b-4期非肾脏替代治疗患者的健康相关生活质量

Health-related quality of life in kidney transplant patients and non-renal replacement therapy patients with chronic kidney disease stages 3b-4.

作者信息

Stømer Une, Bergrem Harald, Gøransson Lasse G

机构信息

Department of Internal Medicine, Unit of Nephrology, Stavanger University Hospital, Stavanger, Norway.

出版信息

Ann Transplant. 2013 Nov 18;18:635-42. doi: 10.12659/AOT.889124.

Abstract

BACKGROUND

Patients with a functioning kidney transplant (Tx) and patients with chronic kidney disease (CKD) not in dialysis report better health-related quality of life (HRQoL) than patients requiring dialysis, but poorer than the general population. HRQoL is associated with kidney function, but it is unknown whether the kidney function per se is the main determinant of HRQoL. The aim of this study was to compare the HRQoL in 2 groups of patients with CKD: 1 group with native kidneys only (non-renal replacement therapy [non-RRT] group) and 1 group with a functioning kidney transplant (Tx group).

MATERIAL/METHODS: The study was designed as a paired cross-sectional single-center study including 38 stable Tx patients age- and gender-matched with 38 non-RRT patients with the same kidney function, CKD stages 3b–4. HRQoL was evaluated using the short form-36 (SF-36) and a visual analogue scale (VAS).

RESULTS

The multi-item scales and summary scores in SF-36 were not significantly different between the 2 groups of patients or the general Norwegian population. However, the non-RRT group scored significantly better than the Tx group when HRQoL was evaluated by VAS. The main determinants for HRQoL in both groups of patients were depression estimated by Beck depression inventory scores and comorbidity expressed by Davies comorbidity index scores.

CONCLUSIONS

HRQoL evaluated by SF-36 in a group of stable Tx patients in CKD stages 3b–4 is comparable to that of a group of non-RRT patients. However, HRQoL VAS was better in the non-RRT group, suggesting that VAS and SF-36 may evaluate different aspects in HRQoL in the same group of patients.

摘要

背景

有功能肾移植(Tx)的患者以及未接受透析的慢性肾脏病(CKD)患者报告的健康相关生活质量(HRQoL)优于需要透析的患者,但比一般人群差。HRQoL与肾功能相关,但肾功能本身是否是HRQoL的主要决定因素尚不清楚。本研究的目的是比较两组CKD患者的HRQoL:一组仅为自身肾脏(非肾脏替代治疗[non-RRT]组),另一组为有功能肾移植(Tx组)。

材料/方法:本研究设计为配对横断面单中心研究,纳入38例稳定的Tx患者,年龄和性别与38例肾功能相同(CKD 3b-4期)的非RRT患者相匹配。使用简短健康调查问卷(SF-36)和视觉模拟量表(VAS)评估HRQoL。

结果

两组患者或挪威一般人群之间,SF-36中的多项目量表和总结分数无显著差异。然而,当通过VAS评估HRQoL时,非RRT组的得分显著高于Tx组。两组患者HRQoL的主要决定因素是通过贝克抑郁量表评分评估的抑郁以及通过戴维斯合并症指数评分表示的合并症。

结论

在CKD 3b-4期的一组稳定Tx患者中,通过SF-36评估的HRQoL与一组非RRT患者相当。然而,非RRT组的HRQoL VAS更好,这表明VAS和SF-36可能评估同一组患者HRQoL的不同方面。

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