Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea.
Clinical Research Center for End Stage Renal Disease, Daegu, South Korea.
Sci Rep. 2019 Jul 16;9(1):10266. doi: 10.1038/s41598-019-46744-1.
This study aimed to compare health-related quality of life (HRQOL) over time in patients initiating hemodialysis (HD) or peritoneal dialysis (PD). A total of 989 incident patients starting HD or PD were included from a prospective nationwide cohort study. HRQOL was assessed 3, 12, and 24 months after the start of dialysis. The scores of questionnaires were adjusted for clinical and socioeconomic parameters. The adjusted three months scores of patients on PD showed better HRQOL in eight end-stage renal disease (ESRD), three physical component summary and one mental component summary domains compared with patients on HD. Both patients on HD and PD experienced significant decreases in different HRQOL domains over two years and the degree of changes in HRQOL over time was not different between dialysis modality. However, the scores of three (effects of kidney disease, burden of kidney disease, and dialysis staff encouragement, all P < 0.05) and two (sexual function and dialysis staff encouragement, all P < 0.05) ESRD domains were still higher in patients on PD compared with patients on HD at one and two years after initiation of dialysis, respectively. PD shows better HRQOL during the initial period after dialysis even after adjusting for clinical and socioeconomic characteristics, and the effect lasts up to two years. It was similar in terms of changes in HRQOL over time between HD and PD.
本研究旨在比较开始血液透析（HD）或腹膜透析（PD）的患者随时间推移的健康相关生活质量（HRQOL）。从一项前瞻性全国队列研究中纳入了总共 989 名开始接受 HD 或 PD 的首发患者。在透析开始后 3、12 和 24 个月评估 HRQOL。问卷的评分经过临床和社会经济参数调整。与 HD 患者相比，PD 患者的调整后三个月的八项终末期肾病（ESRD）、三项生理成分综合和一项心理成分综合领域的 HRQOL 评分更好。HD 和 PD 患者在两年内经历了不同 HRQOL 领域的显著下降，且透析方式之间随时间变化的 HRQOL 程度没有差异。然而，在透析开始后一年和两年，PD 患者在三个（肾病影响、肾病负担和透析人员鼓励，均 P<0.05）和两个（性功能和透析人员鼓励，均 P<0.05）ESRD 领域的评分仍高于 HD 患者。在调整了临床和社会经济特征后，PD 在透析后的初始阶段显示出更好的 HRQOL，并且这种效果持续了两年。在 HRQOL 随时间变化方面，HD 和 PD 之间没有差异。
