Kang Seok Hui, Do Jun Young, Lee So-Young, Kim Jun Chul
Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea.
Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
PLoS One. 2017 May 3;12(5):e0176814. doi: 10.1371/journal.pone.0176814. eCollection 2017.
Health-related quality of life (HRQoL) surveys are needed to evaluate regional and ethnic specificies. The aim of the present study was to evaluate the differences in HRQoL, frailty, and disability according to dialysis modality in the Korean population.
We enrolled relatively stable maintenance dialysis patients. A total of 1,616 patients were recruited into our study. The demographic and laboratory data collected at enrollment included age, sex, comorbidities, frailty, disability, and HRQoL scales.
A total of 1,250 and 366 participants underwent hemodialysis (HD) and peritoneal dialysis (PD), respectively. The numbers of participants with pre-frailty and frailty were 578 (46.2%) and 422 (33.8%) in HD patients, and 165 (45.1%) and 137 (37.4%) in PD patients, respectively (P = 0.349). Participants with a disability included 195 (15.6%) HD patients and 109 (29.8%) PD patients (P < 0.001). On multivariate analysis, the mean physical component scale (PCS) and mental component scale (MCS), symptom/problems, and sleep scores were higher in HD patients than in PD patients. Cox regression analyses showed that an increased PCS in both HD and PD patients was positively associated with patient survival and first hospitalization-free survival. An increased MCS in both HD and PD patients was positively associated with first hospitalization-free survival only.
There was no significant difference in frailty between patients treated with the two dialysis modalities; however, disability was more common in PD patients than in HD patients. The MCS and PCS were more favorable in HD patients than in PD patients. Symptom/problems, sleep, quality of social interaction, and social support were more favorable in HD patients than in PD patients; however, patient satisfaction and dialysis staff encouragement were more favorable in PD patients than in HD patients.
需要进行与健康相关的生活质量（HRQoL）调查以评估地区和种族差异。本研究的目的是评估韩国人群中不同透析方式下HRQoL、衰弱和残疾情况的差异。
我们纳入了病情相对稳定的维持性透析患者。共有1616例患者被纳入本研究。入组时收集的人口统计学和实验室数据包括年龄、性别、合并症、衰弱、残疾和HRQoL量表。
分别有1250例和366例参与者接受了血液透析（HD）和腹膜透析（PD）。HD患者中衰弱前期和衰弱患者的数量分别为578例（46.2%）和422例（33.8%），PD患者中分别为165例（45.1%）和137例（37.4%）（P = 0.349）。残疾患者包括195例（15.6%）HD患者和109例（29.8%）PD患者（P < 0.001）。多因素分析显示，HD患者的平均身体成分量表（PCS）和精神成分量表（MCS）、症状/问题及睡眠评分高于PD患者。Cox回归分析表明，HD和PD患者中PCS升高均与患者生存及首次无住院生存呈正相关。HD和PD患者中MCS升高仅与首次无住院生存呈正相关。
两种透析方式治疗的患者在衰弱方面无显著差异；然而，残疾在PD患者中比HD患者更常见。HD患者的MCS和PCS比PD患者更理想。HD患者的症状/问题、睡眠、社会互动质量及社会支持比PD患者更理想；然而，PD患者的患者满意度和透析工作人员鼓励比HD患者更理想。
