Kıvanç Tülay, Kal Öznur, Çiftçi Öznur, Akçay Şule
From the Department of Pulmonary Medicine, Faculty of Medicine, Baskent University, Konya, Turkey.
Exp Clin Transplant. 2016 Nov;14(Suppl 3):59-63.
Pulmonary hypertension has been reported to occur in a considerable proportion of patients with end-stage renal disease. End-stage renal disease affects the health-related quality of life of patients. There is a lack of specific information on the relation between pulmonary hypertension and health-related quality of life in patients with end-stage renal disease in the literature. We aimed to evaluate this relation in patients undergoing hemodialysis.
This prospective case-control study included 68 patients treated with hemodialysis and 30 healthy participants as controls. Group 1 comprised hemodialysis patients with pulmonary hypertension, group 2 comprised patients without pulmonary hypertension, and group 3 were healthy subjects. Each patient's health-related quality of life was measured with the Medical Outcomes Study 36-Item Short Form health survey. Doppler echocardiography was performed to determine pulmonary artery pressure in all patients. The groups were compared with respect to health-related quality of life.
Pulmonary hypertension was found in 47.1% of patients (mean systolic pulmonary artery pressure of 48.9 ± 11.8 mmHg). Significant differences were observed among the 3 groups regarding the physical function, physical role, bodily pain, general health, vitality, social function, emotional role, mental health, and physical component summary (P = .001). There was no significant correlation between pulmonary artery pressure and health survey scores.
Hemodialysis patients had significantly lower quality of life scores than healthy subjects. There were no significant differences in terms of health survey domains between the hemodialysis patients with and without pulmonary hypertension. This may be due to the severe adverse effects of end-stage renal disease on health-related quality of life. We conclude that, because end-stage renal disease has so many adverse effects on health-related quality of life, the additional effects of pulmonary hypertension on health-related quality of life could not be revealed.
据报道,相当一部分终末期肾病患者会发生肺动脉高压。终末期肾病会影响患者与健康相关的生活质量。文献中缺乏关于终末期肾病患者肺动脉高压与健康相关生活质量之间关系的具体信息。我们旨在评估接受血液透析患者中的这种关系。
这项前瞻性病例对照研究纳入了68例接受血液透析治疗的患者和30名健康参与者作为对照。第1组为患有肺动脉高压的血液透析患者,第2组为无肺动脉高压的患者,第3组为健康受试者。使用医学结局研究36项简表健康调查来测量每位患者的健康相关生活质量。对所有患者进行多普勒超声心动图检查以确定肺动脉压力。比较各组在健康相关生活质量方面的情况。
47.1%的患者存在肺动脉高压(平均收缩期肺动脉压为48.9±11.8 mmHg)。在身体功能、身体角色、身体疼痛、总体健康、活力、社会功能、情感角色、心理健康和身体成分汇总方面,3组之间存在显著差异(P = .001)。肺动脉压力与健康调查评分之间无显著相关性。
血液透析患者的生活质量得分显著低于健康受试者。有肺动脉高压和无肺动脉高压的血液透析患者在健康调查领域方面无显著差异。这可能是由于终末期肾病对健康相关生活质量有严重的不良影响。我们得出结论,由于终末期肾病对健康相关生活质量有诸多不良影响,肺动脉高压对健康相关生活质量的额外影响未能显现出来。