Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
Department of Medicine, Manipal Medical Collage, Melaka, Malaysia.
PLoS One. 2013 Dec 16;8(12):e84152. doi: 10.1371/journal.pone.0084152. eCollection 2013.
Although hemodialysis treatment has greatly increased the life expectancy of end stage renal disease patients, low quality of life among hemodialysis patients is frequently reported. This cross-sectional study aimed to determine the relationship between medical history, hemodialysis treatment and nutritional status with the mental and physical components of quality of life in hemodialysis patients. Respondents (n=90) were recruited from Hospital Kuala Lumpur and dialysis centres of the National Kidney Foundation of Malaysia. Data obtained included socio-demography, medical history, hemodialysis treatment and nutritional status. Mental and physical quality of life were measured using the Mental Composite Summary (MCS) and Physical Composite Summary (PCS) of the Short-Form Health Survey 36-items, a generic core of the Kidney Disease Quality of Life Short Form. Two summary measures and total SF-36 was scored as 0-100, with a higher score indicating better quality of life. Approximately 26 (30%) of respondents achieved the body mass index (24 kg/m(2)) and more than 80% (n=77) achieved serum albumin level (>35.0 mg/dL) recommended for hemodialysis patients. The majority of respondents did not meet the energy (n=72, 80%) and protein (n=68,75%) recommendations. The total score of SF-36 was 54.1 ± 19.2, while the score for the mental and physical components were 45.0 ± 8.6 and 39.6 ± 8.6, respectively. Factors associated with a higher MCS score were absence of diabetes mellitus (p=0.000) and lower serum calcium (p=0.004), while higher blood flow (p=0.000), higher serum creatinine (p=0.000) and lower protein intake (p=0.006) were associated with a higher PCS score. To improve the overall quality of life of hemodialysis patients, a multidisciplinary intervention that includes medical, dietetic and psychosocial strategies that address factors associated with mental and physical quality of life are warranted to reduce further health complications and to improve quality of life.
尽管血液透析治疗大大提高了终末期肾病患者的预期寿命，但经常有报道称血液透析患者的生活质量较低。本横断面研究旨在确定病史、血液透析治疗和营养状况与血液透析患者的身心健康生活质量之间的关系。研究对象（n=90）来自吉隆坡医院和马来西亚国家肾脏基金会的透析中心。收集的数据包括社会人口统计学资料、病史、血液透析治疗和营养状况。使用 36 项简短健康调查的精神综合摘要（MCS）和身体综合摘要（PCS）来衡量精神和身体生活质量，这是肾脏疾病生活质量简短形式的通用核心。两个综合指标和总 SF-36 的评分范围为 0-100，得分越高表示生活质量越好。大约 26%（n=26）的受访者达到了体重指数（24kg/m2），超过 80%（n=77）的受访者达到了血液透析患者推荐的血清白蛋白水平（>35.0mg/dL）。大多数受访者未达到能量（n=72，80%）和蛋白质（n=68，75%）的推荐量。SF-36 的总分是 54.1±19.2，而精神和身体成分的得分为 45.0±8.6 和 39.6±8.6。与较高的 MCS 评分相关的因素是没有糖尿病（p=0.000）和较低的血清钙（p=0.004），而较高的血流量（p=0.000）、较高的血清肌酐（p=0.000）和较低的蛋白质摄入量（p=0.006）与较高的 PCS 评分相关。为了提高血液透析患者的整体生活质量，需要采取多学科干预措施，包括医疗、饮食和社会心理策略，以解决与身心健康生活质量相关的因素，以减少进一步的健康并发症并提高生活质量。
