Luo Laimin, Chen Qinkai
Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, P.R. China.
J Int Med Res. 2020 Feb;48(2):300060519895844. doi: 10.1177/0300060519895844.
This study aimed to investigate the factors influencing health-related quality of life (HRQoL) in patients with different chronic kidney disease–mineral and bone disorder (CKD–MBD) phenotypes.
Patients undergoing maintenance hemodialysis (MHD) at our center from 1 July to 31 August 2017 were enrolled. Patients who received hemodialysis for less than 3 months or displayed poor compliance, or those with incomplete clinical data were excluded. QoL was evaluated using the Kidney Disease Quality of Life–Short Form (KDQOL-SF™) 1.3 scale. The influential factors were stratified based on different CKB–MBD phenotypes.
There were 296 patients enrolled. The serum intact parathyroid hormone (iPTH) concentration was 436.40 ± 490.99 pg/mL, serum calcium (Ca) concentration was 2.14 ±0.27 mmol/L, serum phosphorus (P) concentration was 1.81 ± 0.56 mmol/L, the kidney disease and dialysis-related QoL (KDTA) score was 57.07 ± 10.40, and the SF-36 score was 51.45 ± 17.62. Among patients with different CKD–MBD phenotypes, HRQoL was highest in the group with an iPTH concentration of 150 to 300 pg/mL, serum Ca concentration of <2.10 mmol/L, and serum P concentration of >1.78 mmol/L.
CKD−MBD phenotypes significantly affected HRQoL. Comprehensive management of serum iPTH, Ca, and P levels is important to improve QoL in patients receiving hemodialysis.
本研究旨在调查影响不同慢性肾脏病-矿物质和骨异常（CKD-MBD）表型患者健康相关生活质量（HRQoL）的因素。
纳入2017年7月1日至8月31日在本中心接受维持性血液透析（MHD）的患者。排除透析时间少于3个月、依从性差或临床资料不完整的患者。使用肾脏病生活质量简表（KDQOL-SF™）1.3量表评估生活质量。根据不同的CKB-MBD表型对影响因素进行分层。
共纳入296例患者。血清全段甲状旁腺激素（iPTH）浓度为436.40±490.99 pg/mL，血清钙（Ca）浓度为2.14±0.27 mmol/L，血清磷（P）浓度为1.81±0.56 mmol/L，肾脏病及透析相关生活质量（KDTA）评分为57.07±10.40，SF-36评分为51.45±17.62。在不同CKD-MBD表型的患者中，iPTH浓度为150至300 pg/mL、血清Ca浓度<2.10 mmol/L且血清P浓度>1.78 mmol/L的组HRQoL最高。
CKD-MBD表型显著影响HRQoL。全面管理血清iPTH、Ca和P水平对于改善血液透析患者的生活质量很重要。
