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慢性血液透析患者不依从性及其对患者预后影响的研究。

Study of non-compliance among chronic hemodialysis patients and its impact on patients' outcomes.

作者信息

Ibrahim Salwa, Hossam Mohammed, Belal Dawlat

机构信息

Department of Internal Medicine, Cairo University, Cairo, Egypt.

出版信息

Saudi J Kidney Dis Transpl. 2015 Mar;26(2):243-9. doi: 10.4103/1319-2442.152405.

Abstract

Non-adherence to prescription is common among hemodialysis (HD) patients and has been associated with significant morbidity. At least 50% of HD patients are believed to be non-adherent to some part of their treatment. We aimed to assess the prevalence of non-adherence to dialysis prescription among 100 chronic HD patients. We explored the relationship between non-adherence on one hand and socioeconomic profile, depression scores and cognitive function on the other hand. The impact of patients' non-adherence on nutritional status, quality of life and dialysis adequacy was also assessed. The mean age of the study group was 50.51 ± 12.0 years. There were 62 females and 38 males in the study. Thirty-six patients (36%) were non-compliant to their dialysis prescription. No significant differences were detected between compliant and non-compliant patients in their education level and employment status. Inter-dialytic weight gain, serum phosphorus and depression scores were significantly higher in non-compliant patients compared with compliant patients, whereas body weight, serum albumin, serum calcium, quality of life scores and nutrition scores were significantly higher in compliant patients (P <0.05). In conclusion, non-adherence is highly prevalent among chronic HD patients and is associated with poor quality of life, depression and malnutrition.

摘要

不遵医嘱在血液透析(HD)患者中很常见,且与显著的发病率相关。据信至少50%的HD患者在治疗的某些方面不遵医嘱。我们旨在评估100例慢性HD患者中不遵医嘱接受透析治疗的患病率。我们一方面探讨了不遵医嘱与社会经济状况、抑郁评分和认知功能之间的关系,另一方面评估了患者不遵医嘱对营养状况、生活质量和透析充分性的影响。研究组的平均年龄为50.51±12.0岁。研究中有62名女性和38名男性。36例患者(36%)不遵守透析医嘱。在教育水平和就业状况方面,遵医嘱和不遵医嘱的患者之间未检测到显著差异。与遵医嘱的患者相比,不遵医嘱的患者透析间期体重增加、血清磷和抑郁评分显著更高,而遵医嘱的患者体重、血清白蛋白、血清钙、生活质量评分和营养评分显著更高(P<0.05)。总之,不遵医嘱在慢性HD患者中非常普遍,且与生活质量差、抑郁和营养不良有关。

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