生物电阻抗分析与5期慢性肾脏病透析前阶段、血液透析及腹膜透析患者生活质量之间的关联。
The association between bioimpedance analysis and quality of life in pre-dialysis stage 5 chronic kidney disease, hemodialysis and peritoneal dialysis patients.
作者信息
Yongsiri Somchai, Thammakumpee Jiranuch, Prongnamchai Suriya, Dinchuthai Pakaphan, Chueansuwan Rachaneeporn, Tangjaturonrasme Siriporn, Chaivanit Pechngam
出版信息
J Med Assoc Thai. 2014 Mar;97(3):293-9.
BACKGROUND
Protein-energy wasting is a significant problem in End stage renal disease (ESRD) patients. Furthermore, it compromises the patient's Quality of life (QOL). Multifrequency Bioimpedance Spectroscopy (BIS) is a validated method to assess body composition in dialysis patients. There has been no data on the relationship between body composition and QOL in ESRD patients who were treated with different modalities.
OBJECTIVE
To explore the association between body composition as assessed by BIS and QOL in ESRD patients who received different treatment modalities.
MATERIAL AND METHOD
The present study is a cross sectional, descriptive analytic study of the association between QOL and BIS in ESRD patients in Burapha University, Chonburi, Thailand. QOL was assessed by WHOQOL-BREF questionnaire, body composition was measured by BIS technique. The difference between groups was tested by one-way ANOVA test, relationship between groups was tested with Pearson correlation test.
RESULTS
Eighteen predialysis-CKD5, 26 peritoneal dialysis (PD), and 34 hemodialysis (HD) patients were included in the present study. All PD patients had weekly Kt/V > or = 1.7 per week and all HD patients had weekly Kt/V > or = 3.6 per week. There were no statistically difference in baseline characteristics including Charlson comorbidity index, dietary intake, BMI, and blood pressure between groups. Mean QOL scores in each group were in the middle range and not significantly difference. PD patients had more over hydration when compare to HD patients (16.18 +/- 11.24 vs. 2.36 +/- 11.07 %OH/ECW p < 0.0001). There were inversed correlation between overhydration and physical health in HD patients (r = -0.372, p = 0.033) but not in PD and CKD5 patients. CKD5 patients had more lean tissue index (LTI) than PD and HD patients (LTI = 14.34 +/- 3.13, 12.26 +/- 3.65, 11.48 +/- 3.48 kg/m2 respectively, p = 0.023). There were correlation between LTI and overall QOL in CKD5 (r = 0.690, p = 0.002) and PD patients (r = 0.498, p = 0.010). In HD patients, LTI was associated with better physical health (r = 0.464, p = 0.007).
CONCLUSION
QOL in predialysis-CKD5, PD and HD patients were not statistically different. HD patients had better volume control than PD patients. Higher LTI were associated with better QOL in ESRD patients.
背景
蛋白质能量消耗是终末期肾病（ESRD）患者的一个重要问题。此外，它还会损害患者的生活质量（QOL）。多频生物电阻抗光谱法（BIS）是一种用于评估透析患者身体成分的有效方法。目前尚无关于接受不同治疗方式的ESRD患者身体成分与生活质量之间关系的数据。
目的
探讨通过BIS评估的身体成分与接受不同治疗方式的ESRD患者生活质量之间的关联。
材料与方法
本研究是一项横断面描述性分析研究，旨在探讨泰国春武里府博拉帕大学ESRD患者生活质量与BIS之间的关联。生活质量通过WHOQOL - BREF问卷进行评估，身体成分通过BIS技术进行测量。组间差异采用单因素方差分析进行检验，组间关系采用Pearson相关检验进行检验。
结果
本研究纳入了18例透析前慢性肾脏病5期（CKD5）患者、26例腹膜透析（PD）患者和34例血液透析（HD）患者。所有PD患者每周的Kt/V≥1.7，所有HD患者每周的Kt/V≥3.6。各组之间在基线特征（包括Charlson合并症指数、饮食摄入量、体重指数和血压）方面无统计学差异。每组的平均生活质量得分均处于中等范围，且无显著差异。与HD患者相比，PD患者的水钠潴留更多（16.18±11.24 vs. 2.36±11.07 %OH/ECW，p < 0.0001）。HD患者的水钠潴留与身体健康呈负相关（r = -0.372，p = 0.033），而在PD和CKD5患者中则无此相关性。CKD5患者的瘦组织指数（LTI）高于PD和HD患者（LTI分别为14.34±3.13、12.26±3.65、11.48±3.48 kg/m²，p = 0.023）。CKD5患者（r = 0.690，p = 0.002）和PD患者（r = 0.498，p = 0.010）的LTI与总体生活质量之间存在相关性。在HD患者中，LTI与更好的身体健康相关（r = 0.464，p = 0.007）。
结论
透析前CKD5、PD和HD患者的生活质量在统计学上无差异。HD患者的容量控制优于PD患者。较高的LTI与ESRD患者更好的生活质量相关。
Zotero 插件