University of Alabama at Birmingham-School of Nursing, Birmingham, AL, USA.
University of Alabama at Birmingham-School of Medicine, Birmingham, USA.
Qual Life Res. 2021 Mar;30(3):759-768. doi: 10.1007/s11136-020-02684-2. Epub 2020 Oct 27.
Lifestyle changes associated with end-stage renal disease may be a factor in depression and quality of life (QOL) for patients receiving hemodialysis. This cross-sectional study examined the relationship between nutritional status, QOL, and depression in 124 hemodialysis patients.
Nutritional markers included serum albumin, normalized protein catabolic rate (nPCR), body mass index (BMI), body fat percentage, and daily protein intake. Physical and Mental dimension scores of the Kidney Disease QOL-Short Form (KDQOL-SF), and the Center for Epidemiological Studies of Depression (CESD) survey were used to measure QOL and depression, respectively. Data were analyzed using regression analyses. Measures of effect size were used for interpretation.
Nutritional status indicators explained a moderate amount of the variability of the Physical dimension of QOL (crude R = .14, covariate-adjusted ΔR = .06) but had weak explanatory ability for the Mental dimension of QOL (crude R = .05, covariate-adjusted ΔR = .02) and CESD (crude R = .02, covariate-adjusted ΔR = .005). Additional findings suggested the presence of non-linear relationships between protein intake and both the Physical and Mental QOL dimension scores. Longer dialysis vintage was also correlated with lower psychosocial patient outcomes.
While nutritional status is an important element in predicting hemodialysis patient outcomes, its relationship to depression and QOL, in this sample, demonstrated only moderate explanatory ability. However, dialysis vintage and level of education had a significant relationship with depression and QOL. These findings suggest that patients with longer dialysis vintage and limited health literacy require unique plans of care. Future studies aimed at understanding the interrelationships between non-modifiable patient characteristics and psychosocial outcomes are imperative.
与终末期肾病相关的生活方式改变可能是接受血液透析的患者抑郁和生活质量（QOL）的一个因素。本横断面研究调查了 124 名血液透析患者的营养状况、QOL 和抑郁之间的关系。
营养标志物包括血清白蛋白、标准化蛋白分解率（nPCR）、体重指数（BMI）、体脂肪百分比和每日蛋白质摄入量。使用肾脏病生活质量-短表（KDQOL-SF）的身体和精神维度评分以及流行病学研究抑郁量表（CESD）调查分别衡量 QOL 和抑郁。使用回归分析进行数据分析。使用效应大小度量进行解释。
营养状况指标解释了 QOL 身体维度的中等程度的变异性（原始 R =.14，协变量调整后的ΔR =.06），但对 QOL 心理维度（原始 R =.05，协变量调整后的ΔR =.02）和 CESD（原始 R =.02，协变量调整后的ΔR =.005）的解释能力较弱。其他发现表明，蛋白质摄入量与身体和心理 QOL 维度评分之间存在非线性关系。更长的透析龄也与较低的心理社会患者结局相关。
虽然营养状况是预测血液透析患者结局的一个重要因素，但在本样本中，它与抑郁和 QOL 的关系仅表现出中等的解释能力。然而，透析龄和教育水平与抑郁和 QOL 有显著关系。这些发现表明，透析龄较长和健康素养有限的患者需要独特的护理计划。未来的研究旨在了解不可改变的患者特征和心理社会结局之间的相互关系是至关重要的。
