Küçük O, Kaynar K, Arslan F C, Ulusoy Ş, Gül H K, Çelik A, Çan G
Department of Internal Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Department of Nephrology,Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Hippokratia. 2020 Apr-Jun;24(2):51-58.
The present study aimed to investigate and compare mental health, health-related quality of life, and sleep levels of patients with various stages of chronic kidney disease (CKD) and undergoing different renal replacement therapies and analyze the factors affecting these parameters.
Overall, 140 patients with a mean age of 43 ± 14 years were recruited into this study. Study groups [controls and patients with CKD undergoing predialysis, hemodialysis (HD), peritoneal dialysis, kidney transplantation (KT)] were evaluated using Short Form Health Survey-36 (SF-36), Kidney Disease Quality of Life-36 (KDQoL-36), Pittsburgh Sleep Quality Index (PSQI), and General Health Questionnaire-12 (GHQ-12).
The KT group had the highest scores in physical and mental components of the subscales of SF-36 and KDQoL-36 but the lowest scores in PSQI and GHQ-12, indicating the best results in terms of mental health and quality of life, and sleep. Serum albumin and hemoglobin levels were positively correlated with several subscales of quality of life. Significant negative correlations were observed among PSQI, GHQ-12, and subscale scores of SF-36 and KDQoL-36. The HD group showed significantly lower scores in the subscales of symptoms and burden of kidney disease of KDQoL-36.
KDQoL was worse in the HD group and better in the KT group than in other groups. Serum albumin and hemoglobin levels, and Kt/V (dialyzer clearance of urea multiplied by dialysis time and normalized for urea distribution volume ) values of patients with CKD exerted a linear and significant effect on the quality of life, which showed a significant positive correlation with the quality of sleep and mental health. In contrast, serum calcium x phosphorus levels showed an inverse correlation with the subscale scores of KDQoL. HIPPOKRATIA 2020, 24(2): 51-58.
本研究旨在调查和比较不同阶段慢性肾脏病（CKD）患者以及接受不同肾脏替代治疗患者的心理健康状况、健康相关生活质量和睡眠水平，并分析影响这些参数的因素。
本研究共纳入140例平均年龄为43±14岁的患者。研究组[对照组以及接受透析前治疗、血液透析（HD）、腹膜透析、肾移植（KT）的CKD患者]使用简明健康调查量表-36（SF-36）、肾脏病生活质量量表-36（KDQoL-36）、匹兹堡睡眠质量指数（PSQI）和一般健康问卷-12（GHQ-12）进行评估。
肾移植组在SF-36和KDQoL-36分量表的生理和心理成分方面得分最高，但在PSQI和GHQ-12方面得分最低，表明在心理健康、生活质量和睡眠方面效果最佳。血清白蛋白和血红蛋白水平与生活质量的几个分量表呈正相关。PSQI、GHQ-12与SF-36和KDQoL-36的分量表得分之间存在显著负相关。血液透析组在KDQoL-（）36的肾脏病症状和负担分量表中得分显著较低。
血液透析组的KDQoL比其他组差，肾移植组的KDQoL比其他组好。CKD患者的血清白蛋白和血红蛋白水平以及Kt/V（透析器尿素清除率乘以透析时间并根据尿素分布容积进行标准化）值对生活质量有线性且显著的影响，生活质量与睡眠质量和心理健康呈显著正相关。相比之下，血清钙×磷水平与KDQoL的分量表得分呈负相关。《希波克拉底》2020年，24（2）：51-58。
