Department of Nephrology, The Second People's Hospital of Shantou, Shantou, Guangdong, China (mainland).
Department of Pharmacy, The Second People's Hospital of Shantou, Shantou, Guangdong, China (mainland).
Med Sci Monit. 2022 Feb 6;28:e934282. doi: 10.12659/MSM.934282.
BACKGROUND This study compared the effects of peritoneal dialysis and hemodialysis on cognitive dysfunction and health-related quality of life (HRQOL) in end-stage renal disease (ESRD) patients and analyzed other potential influencing factors. MATERIAL AND METHODS A total of 265 patients who received dialysis at our hospital were included and divided into the hemodialysis group (n=115) and the peritoneal dialysis group (n=150). The cognitive performance was assessed by the Beijing version of the Montreal Cognitive Assessment. The Kidney Disease Quality of 36-Item Short Form Survey and a kidney disease-related quality of life assessment were used for evaluating HRQOL. Univariate and multivariate linear regression analyses were used to explore the effects of dialysis on cognitive dysfunction and HRQOL. RESULTS As compared with the hemodialysis group, the peritoneal dialysis group had lower scores on the Montreal Cognitive Assessment (ß=-8.35, 95% CI: -9.85 to -6.86), 36-Item Short Form Survey (ß=-10.20, 95% CI: -11.94 to -8.45), and kidney disease-related quality of life assessment (ß=-8.67, 95% CI: -10.10 to -7.23). After adjustment for sex, age, BMI, marital status, educational level, income level, presence of diabetes, duration of kidney disease, duration of dialysis, and dialysis frequency, the results were consistent with that of the crude model. CONCLUSIONS In the present study, patients receiving peritoneal dialysis had worse cognitive dysfunction and worse HRQOL compared to patients receiving hemodialysis, which might lead to poorer outcomes of ESRD patients. The related factors affecting cognitive dysfunction and HRQOL were also explored, which could help clinicians to determine the optimal treatment for ESRD patients.
本研究比较了腹膜透析和血液透析对终末期肾病（ESRD）患者认知功能障碍和健康相关生活质量（HRQOL）的影响，并分析了其他潜在的影响因素。
共纳入 265 例在我院接受透析的患者，分为血液透析组（n=115）和腹膜透析组（n=150）。采用北京版蒙特利尔认知评估量表评估认知表现。采用肾脏病生活质量 36 项简表和肾脏病相关生活质量评估评估 HRQOL。采用单因素和多因素线性回归分析探讨透析对认知功能障碍和 HRQOL 的影响。
与血液透析组相比，腹膜透析组蒙特利尔认知评估量表评分较低（ß=-8.35，95%CI：-9.85 至-6.86）、肾脏病生活质量 36 项简表评分较低（ß=-10.20，95%CI：-11.94 至-8.45）和肾脏病相关生活质量评估评分较低（ß=-8.67，95%CI：-10.10 至-7.23）。在校正性别、年龄、BMI、婚姻状况、教育水平、收入水平、糖尿病、肾脏病病程、透析病程和透析频率后，结果与粗模型一致。
本研究中，腹膜透析患者的认知功能障碍和 HRQOL 较血液透析患者差，可能导致 ESRD 患者预后较差。还探讨了影响认知功能障碍和 HRQOL 的相关因素，有助于临床医生为 ESRD 患者确定最佳治疗方案。
