Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing City, Jiangsu Province, China.
J Vasc Access. 2024 Mar;25(2):439-447. doi: 10.1177/11297298221113283. Epub 2022 Aug 1.
Vascular access (VA) is known to be critical for the survival of patients on maintained hemodialysis (MHD) treatment. However, the association between VA satisfaction and psychiatric state in MHD patients is still not fully elucidated. Thus, the aim of this study is to evaluate the relationship among VA satisfaction, health-related quality of life (HRQOL) and depression in MHD patients with different VA types.
This cross-sectional study was conducted at two dialysis centers with MHD-dependent patients. The Short Form Vascular Access Questionnaire (VAQ) was administered to estimate the level of MHD patients' satisfaction with their VA. HRQOL was assessed using the Short Form 36 (SF-36) questionnaire. Depression was assessed using the Zung's self-rating depression scale (SDS).
Of the total 252 patients, AVF was used by 84.13%, AVG was used by 2.78%, and TCC was used by 13.09%. There was no significant difference in satisfaction and SDS scores by access type in patients with AVF, AVG, and TCC. However, HRQOL was worst in patients with TCC, and highest in the AVF group. Further analysis showed that VAQ scores in the domains of overall and dialysis-related complications exhibited a negative correlation with HRQOL. And SF-36 HRQOL scores, including the total score, PCS and MCS, were all negatively correlated with SDS scores ( < 0.05). The results of multivariable analyses found that VAQ scores in the domains of overall score and physical symptom, and total score of HRQOL influenced the depression.
In the present study, no significant difference in satisfaction scores by access type was found in patients with AVF, AVG, and TCC. The HRQOL score was higher in patients with AVF than in those with AVG or TCC. And the result suggested a negative association between HRQOL and depression. Vascular access satisfaction and HRQOL might be risk factors for the presence of depression in MHD patients.
血管通路（VA）对于维持性血液透析（MHD）患者的生存至关重要。然而，MHD 患者 VA 满意度与精神状态之间的关系尚未完全阐明。因此，本研究旨在评估不同 VA 类型的 MHD 患者中 VA 满意度、健康相关生活质量（HRQOL）和抑郁之间的关系。
这是一项在两家透析中心进行的横断面研究，纳入了 MHD 依赖患者。采用简易血管通路问卷（VAQ）评估 MHD 患者对 VA 的满意度水平。采用健康调查简表 36 项（SF-36）评估 HRQOL。采用zung 氏抑郁自评量表（SDS）评估抑郁。
在 252 例患者中，动静脉内瘘（AVF）使用率为 84.13%，血管通路移植物（AVG）使用率为 2.78%，经皮血管腔内成形术（TCC）使用率为 13.09%。AVF、AVG 和 TCC 患者的 VA 满意度和 SDS 评分在不同 VA 类型之间无显著差异。然而，TCC 患者的 HRQOL 最差，AVF 组最高。进一步分析显示，VAQ 总体和透析相关并发症领域的评分与 HRQOL 呈负相关。SF-36 HRQOL 评分，包括总分、PCS 和 MCS，均与 SDS 评分呈负相关（ < 0.05）。多变量分析结果发现，VAQ 总体评分和躯体症状、HRQOL 总分领域的评分影响抑郁。
在本研究中，AVF、AVG 和 TCC 患者的 VA 满意度评分在不同 VA 类型之间无显著差异。AVF 患者的 HRQOL 评分高于 AVG 或 TCC 患者。结果提示 HRQOL 与抑郁呈负相关。VA 满意度和 HRQOL 可能是 MHD 患者抑郁发生的危险因素。
