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评估发展中国家血液透析患者生活质量决定因素:在持续的 COVID-19 大流行期间进行的横断面研究。

Assessment of quality of life determinants in hemodialysis patients of a developing country: A cross-sectional study during ongoing COVID-19 pandemic.

机构信息

Department of Internal Medicine, Dow University of Health Sciences-Ojha Campus, Karachi, Pakistan.

Department of Nephrology, Dow University of Health Sciences-Ojha Campus, Karachi, Pakistan.

出版信息

Medicine (Baltimore). 2022 Aug 5;101(31):e29305. doi: 10.1097/MD.0000000000029305.

Abstract

BACKGROUND AND OBJECTIVES

Patients of end-stage renal disease are prone to have a very low quality of life (QoL). Variety of factors influence the QoL among sufferers of chronic kidney disease comprising of type of dialysis, sufficiency/adequacy of dialysis, and associated burden of disease. We conducted this study amidst the pandemic to determine the associated factors for poor QoL in hemodialysis patients during the ongoing pandemic.

PATIENTS AND METHODS

This cross-sectional study was conducted in a hemodialysis unit of a tertiary care hospital. A total of 118 participants responded to the validated questionnaire of Quality of Life Index-dialysis version-III (QLI). Higher scores signify good QoL, total scores are further categorized into subgroups desirable, relatively desirable and undesirable.

RESULTS

The mean age of the participants was 57.36 ± 10.03 years and mean body mass index of 26.73 ± 5.54 kg/m2. The mean total QoL of the study population was found quite low (12.99 ± 5.89). Majority of respondents fell in undesirable category of QoL (49.2%). Total QoL (P = 0.004) and subscale health/functioning (P = 0.003) were significantly lower in females. All the subscales along with total QoL scores were found lower in twice-weekly dialyzed patients (P < 0.001). Marital status (P = 0.049) and twice-weekly dialysis (P < 0.001) were found significant with undesirable QoL. On multivariate analysis, significant determinants of undesirable QoL were twice-weekly dialysis (P = 0.001), catheter access (P = 0.034), phosphate (P = 0.005) and uric acid (P = 0.006).

CONCLUSION

Inadequate dialysis due to lesser frequency per week leading to poorly cleared toxic substances were most significant contributors of poor QoL in our study.

摘要

背景和目的

终末期肾病患者的生活质量(QoL)通常很低。多种因素会影响慢性肾脏病患者的 QoL,包括透析类型、透析充分性/适当性以及疾病相关负担。我们在疫情期间进行了这项研究,旨在确定当前疫情期间血液透析患者生活质量较差的相关因素。

患者和方法

这是一项在一家三级医院血液透析病房进行的横断面研究。共有 118 名参与者对经过验证的生活质量指数-透析版 III(QLI)问卷做出了回应。得分越高表示 QoL 越好,总分进一步分为理想、相对理想和不理想亚组。

结果

参与者的平均年龄为 57.36±10.03 岁,平均体重指数为 26.73±5.54kg/m2。研究人群的平均总 QoL 得分较低(12.99±5.89)。大多数受访者属于 QoL 不理想类别(49.2%)。女性的总 QoL(P=0.004)和健康/功能亚量表(P=0.003)显著较低。每周两次透析的所有亚量表以及总 QoL 评分均较低(P<0.001)。婚姻状况(P=0.049)和每周两次透析(P<0.001)与不理想的 QoL 显著相关。多变量分析显示,每周两次透析(P=0.001)、导管通路(P=0.034)、磷酸盐(P=0.005)和尿酸(P=0.006)是不理想 QoL 的显著决定因素。

结论

每周透析频率较低导致清除毒素的效果较差,是导致我们研究中患者 QoL 较差的最重要因素。

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