Zhou Wei, Hu Weifeng, Han Guofeng, Wang Huiling, Zhang Jinyuan, Mei Changlin
Clin Nephrol. 2018 Aug;90(2):106-111. doi: 10.5414/CN109064.
Residual renal function (RRF) is a crucial factor that plays an important role in peritoneal dialysis (PD) patients, but whether RRF influences the quality of life (QOL) of PD patients is still controversial. The aims of this study were to explore the effects of RRF on QOL in patients with continuous ambulatory peritoneal dialysis (CAPD) and analyze the related factors that might affect patients' QOL.
All 120 adult patients in this study received regular CAPD treatment for at least 3 months. Patients were divided into two groups: an RRF group (residual glomerular filtration (rGFR) ≥ 1 mL×min-1×(1.73m2)-1) and a non-RRF group (rGFR ≥ 1 mL×min-1×(1.73m2)-1). The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) was used as a reference to calculate the scores of CAPD patients for assessing their QOL. Multiple- and single-linear regression analysis was performed to analyze correlation degree of several SF-36-related indexes.
The indexes of age, gender, cause of disease, complication, body mass index (BMI), systolic and diastolic blood pressure (SBP and DBP), hemoglobin (HB), cholesterol, triglycerides, high- and low-density lipoprotein, normalized protein catabolic rate (nPCR), and cardiothoracic ratio (CTR) showed no difference between the two groups (RRF and non-RRF). Comparing with RRF group, the patients without RRF showed a significant difference on indexes of PD duration, urine volume, ultrafiltration volume, dialysis dose, serum albumin, potassium, Kt/V (urea reduction ratio), creatinine, calcium, phosphate, C-reactive protein (CRP), and parathyroid hormone (PTH). Single-linear regression analysis that achieved total score of SF-36 showed no correlation with rGFR, but there was a correlation of SF-36 score with CRP, creatinine, CTR, albumin, and ultrafiltration volume.
CONCLUSION: These results suggested that there was no correlation between RRF and QOL in CAPD patients, but chronic inflammation, fluid overload, and malnutrition were considered as the main factors that affect patients' QOL. .
残余肾功能（RRF）是腹膜透析（PD）患者的一个关键因素，在其中发挥着重要作用，但RRF是否会影响PD患者的生活质量（QOL）仍存在争议。本研究旨在探讨RRF对持续非卧床腹膜透析（CAPD）患者QOL的影响，并分析可能影响患者QOL的相关因素。
本研究中的120例成年患者均接受规律的CAPD治疗至少3个月。患者被分为两组：RRF组（残余肾小球滤过率（rGFR）≥1 mL×min-1×(1.73m2)-1）和非RRF组（rGFR＜1 mL×min-1×(1.73m2)-1）。以医学结局研究简明健康调查问卷（SF-36）为参照来计算CAPD患者的得分，以评估其QOL。进行多线性和单线性回归分析，以分析几个与SF-36相关指标的相关程度。
两组（RRF组和非RRF组）在年龄、性别、病因、并发症、体重指数（BMI）、收缩压和舒张压（SBP和DBP）、血红蛋白（HB）、胆固醇、甘油三酯、高密度和低密度脂蛋白、标准化蛋白分解代谢率（nPCR）以及心胸比（CTR）等指标上无差异。与RRF组相比，无RRF的患者在PD时长、尿量、超滤量、透析剂量、血清白蛋白、钾、Kt/V（尿素清除率）、肌酐、钙、磷、C反应蛋白（CRP）和甲状旁腺激素（PTH）等指标上存在显著差异。单线性回归分析显示，SF-36总分与rGFR无相关性，但SF-36得分与CRP、肌酐、CTR、白蛋白和超滤量存在相关性。
这些结果表明，CAPD患者的RRF与QOL之间无相关性，但慢性炎症、液体超负荷和营养不良被认为是影响患者QOL的主要因素。
