Turkmen Kultigin, Guney Ibrahim, Yazici Raziye, Arslan Sevket, Altintepe Lutfullah, Yeksan Mehdi
Division of Nephrology, Department of Internal Medicine, Erzincan University Mengucek Gazi Training and Research Hospital , Erzincan , Turkey .
Ren Fail. 2014 Jul;36(6):859-64. doi: 10.3109/0886022X.2014.899874. Epub 2014 Mar 24.
Impairment of health-related quality of life (HRQoL) and being in a depressive mood were found to be associated with increased mortality in peritoneal dialysis (PD) patients. We aimed to investigate the association between HRQoL, depression, other factors and mortality in PD patients.
Totally 171 PD patients were included and followed for 7 years in this prospective study.
Of 171 PD patients, 45 (26.3%) deceased, 18 (10.5%) maintained on PD, 87 (50.9%) shifted to hemodialysis (HD) and 21 (12.3%) underwent transplantation. The most common cause of death was cardiovascular disease (32, 71.1%) followed by infection (6, 13.3%), cerebrovascular accident (5, 11.2%). The etiology of patients who shifted to HD was PD failure (41, 47.1%), peritonitis (33, 37.9%), leakage (6, 6.9%), catheter dysfunction (3, 3.4%), self willingness (4, 4.6%). Non-survivors were older than survivors (56.6 ± 15.0 vs. 43.6 ± 14.6, p = 0.003). There were also statistically significant difference in terms of albumin, residual urine, presence of diabetes and co-morbidity. When the groups were compared regarding HRQoL scores, non-survivors had lower physical functioning (p < 0.001), role-physical (p = 0.0045), general health (p = 0.004), role-emotional (p = 0.011), physical component scale (PCS) (p = 0.004), mental component scale (MCS) (p = 0.029). Age, presence of residual urine, diabetes, albumin, PCS and MCS were entered in regression analysis. Decrease of 1 g/dL of albumin and being diabetic were found to be the independent predictors of mortality.
Diabetes and hypoalbuminemia but not HRQOL scores were associated with higher mortality in PD patients after 7 years of following period.
研究发现，腹膜透析（PD）患者的健康相关生活质量（HRQoL）受损及情绪抑郁与死亡率增加有关。我们旨在调查PD患者的HRQoL、抑郁、其他因素与死亡率之间的关联。
本前瞻性研究共纳入171例PD患者，并对其进行了7年的随访。
171例PD患者中，45例（26.3%）死亡，18例（10.5%）继续接受PD治疗，87例（50.9%）转为血液透析（HD），21例（12.3%）接受了移植。最常见的死亡原因是心血管疾病（32例，71.1%），其次是感染（6例，13.3%）、脑血管意外（5例，11.2%）。转为HD的患者的病因是PD衰竭（41例，47.1%）、腹膜炎（33例，37.9%）、渗漏（6例，6.9%）、导管功能障碍（3例，3.4%）、自身意愿（4例，4.6%）。非幸存者比幸存者年龄大（56.6±15.0 vs. 43.6±14.6，p = 0.003）。在白蛋白、残余尿量、糖尿病的存在及合并症方面也存在统计学显著差异。当比较各小组的HRQoL评分时，非幸存者的身体功能（p < 0.001）、角色-身体（p = 0.0045）、总体健康（p = 0.004）、角色-情感（p = 0.011）、身体成分量表（PCS）（p = 0.004）、心理成分量表（MCS）（p = 问题029）较低。将年龄、残余尿量的存在、糖尿病、白蛋白、PCS和MCS纳入回归分析。发现白蛋白每降低1 g/dL及患有糖尿病是死亡率的独立预测因素。
在7年的随访期后，糖尿病和低白蛋白血症而非HRQOL评分与PD患者较高的死亡率相关。
