School of Public Health, Fudan University, Shanghai, China.
China Research Center on Disability, Fudan University, Shanghai, China.
PeerJ. 2022 Jan 17;10:e12793. doi: 10.7717/peerj.12793. eCollection 2022.
To analyze the health-related quality of life associated with the conversion of dialysis modality among end-stage renal disease patients in China.
Patients were recruited from hospitals and a dialysis center in Kunshan, China. Patients converting from continuous ambulatory peritoneal dialysis to automated peritoneal dialysis were recruited as the observation group ( = 64), and patients continuing with continuous ambulatory peritoneal dialysis treatment were included in the control group ( = 64) after matching in this retrospective cohort study. Their health-related quality of life was measured using the kidney disease quality of life instrument in 2019 and 2020, respectively. Baseline socio-demographic characteristics and clinical data were collected in 2019. The before-and-after cross-group comparisons of subscale scores of two groups were conducted using a Student's t-test. Multiple linear regression models were fitted to identify the factors associated with the change of each scale.
The health-related quality of life scores of the two groups was comparable in baseline, while the observation group had higher scores in Physical Component Summary (51.92 ± 7.50), Kidney Disease Component Summary (81.21 ± 8.41), Symptoms (90.76 ± 6.30), Effects (82.86 ± 11.42), and Burden (69.04 ± 15.69) subscales after one year. In multivariate regression analysis, the change of Physical Component Summary was significantly associated with conversion to APD ( = 11.54, 95% CI [7.26-15.82]); the change of Mental Component Summary with higher education ( = - 5.96, 95% CI [-10.18--1.74]) and CCI (>2) ( = 5.39, 95% CI [1.05-9.73]); the change of Kidney Disease Component Summary with conversion to APD ( = 15.95, 95% CI [10.19-21.7]) and age (>60 years) ( = - 7.36, 95% CI [-14.11--0.61]); the change of Symptoms with CCI (>2) ( = 7.96, 95% CI [1.49-14.44]); the change of Effects with conversion to APD ( = 19.23, 95% CI [11.57-26.88]); and the change of Burden with conversion to APD ( = 22.40, 95% CI [13.46-31.34]), age (>60 years) ( = - 12.12, 95% CI [-22.59--1.65]), and higher education ( = - 10.38, 95% CI [-19.79--0.98]).
The conversion of dialysis modality had a significant impact on the scores of most subscales. Patients converting from continuous ambulatory peritoneal dialysis to automated peritoneal dialysis generally had improved health-related quality of life scores.
分析中国终末期肾病患者透析方式转换与健康相关生活质量的关系。
本研究采用回顾性队列研究方法，在江苏省昆山市的医院和透析中心招募患者。将从持续不卧床腹膜透析转为自动化腹膜透析的患者作为观察组（n=64），将继续接受持续不卧床腹膜透析治疗的患者作为对照组（n=64），在匹配后于 2019 年和 2020 年分别使用肾脏病生活质量量表评估其健康相关生活质量。2019 年收集基线社会人口统计学特征和临床数据。采用学生 t 检验比较两组各亚量表评分的组间前后变化。采用多元线性回归模型确定与各量表变化相关的因素。
两组基线健康相关生活质量评分相当，而观察组在生理成分综合评分（51.92±7.50）、肾脏病成分综合评分（81.21±8.41）、症状（90.76±6.30）、影响（82.86±11.42）和负担（69.04±15.69）亚量表的评分在一年后更高。多元回归分析显示，生理成分综合评分的变化与转为自动化腹膜透析显著相关（β=11.54，95%CI [7.26-15.82]）；心理成分综合评分的变化与受教育程度较高（β=-5.96，95%CI [-10.18--1.74]）和 CCI（>2）（β=5.39，95%CI [1.05-9.73]）有关；肾脏病成分综合评分的变化与转为自动化腹膜透析（β=15.95，95%CI [10.19-21.7]）和年龄（>60 岁）（β=-7.36，95%CI [-14.11--0.61]）有关；症状的变化与 CCI（>2）（β=7.96，95%CI [1.49-14.44]）有关；影响的变化与转为自动化腹膜透析（β=19.23，95%CI [11.57-26.88]）有关；负担的变化与转为自动化腹膜透析（β=22.40，95%CI [13.46-31.34]）、年龄（>60 岁）（β=-12.12，95%CI [-22.59--1.65]）和受教育程度较高（β=-10.38，95%CI [-19.79--0.98]）有关。
透析方式的转换对大多数亚量表的评分有显著影响。从持续不卧床腹膜透析转为自动化腹膜透析的患者通常健康相关生活质量评分更高。
