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慢性肾脏病-矿物质和骨异常(CKD-MBD)表型对维持性血液透析患者健康相关生活质量的影响:一项横断面研究。

Effect of CKD-MBD phenotype on health-related quality of life in patients receiving maintenance hemodialysis: A cross-sectional study.

作者信息

Luo Laimin, Chen Qinkai

机构信息

Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, P.R. China.

出版信息

J Int Med Res. 2020 Feb;48(2):300060519895844. doi: 10.1177/0300060519895844.

Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

CKD−MBD phenotypes significantly affected HRQoL. Comprehensive management of serum iPTH, Ca, and P levels is important to improve QoL in patients receiving hemodialysis.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a95/7105727/4c11aafb0fd1/10.1177_0300060519895844-fig1.jpg

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