Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands.
Department of Internal Medicine, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands.
Nephrol Dial Transplant. 2024 Feb 28;39(3):436-444. doi: 10.1093/ndt/gfad179.
Patients on haemodialysis (HD) generally experience poor health-related quality of life (HRQoL) and a broad range of physical and mental symptoms, but it is unknown whether this differs between younger and older patients. We aimed to describe the trajectories of HRQoL and symptom burden of patients <70 and ≥70 years old and to assess the impact of symptom burden on HRQoL.
In incident Dutch HD patients, HRQoL and symptoms were measured with the 12-item Short Form Health Survey and Dialysis Symptom Index. We used linear mixed models for examining the trajectories of HRQoL and symptom burden during the first year of dialysis and linear regression for the impact of symptom burden on HRQoL.
In 774 patients, the trajectories of physical HRQoL, mental HRQoL and symptom burden were stable during the first year of dialysis. Compared with patients <70 years of age, patients ≥70 years reported similar physical HRQoL {mean difference -0.61 [95% confidence interval (CI) -1.86-0.63]}, better mental HRQoL [1.77 (95% CI 0.54-3.01)] and lower symptom burden [-2.38 (95% CI -5.08-0.32)]. With increasing symptom burden, physical HRQoL declined more in older than in younger patients (β = -0.287 versus -0.189, respectively; P-value for interaction = .007). For mental HRQoL, this decrease was similar in both age groups (β = -0.295 versus -0.288, P = .847).
Older HD patients generally experience a better mental HRQoL and a (non-statistically significant) lower symptom burden compared with younger patients. Their physical HRQoL declines more rapidly with increasing symptom burden.
接受血液透析（HD）的患者通常经历较差的健康相关生活质量（HRQoL）和广泛的身体和精神症状，但尚不清楚年轻患者和老年患者之间是否存在差异。我们旨在描述<70 岁和≥70 岁患者的 HRQoL 和症状负担轨迹，并评估症状负担对 HRQoL 的影响。
在新入组的荷兰血液透析患者中，使用 12 项简短健康调查和透析症状指数测量 HRQoL 和症状。我们使用线性混合模型来检查透析第一年 HRQoL 和症状负担的轨迹，并使用线性回归来评估症状负担对 HRQoL 的影响。
在 774 名患者中，身体 HRQoL、心理 HRQoL 和症状负担的轨迹在透析的第一年是稳定的。与<70 岁的患者相比，≥70 岁的患者报告了相似的身体 HRQoL{平均差异-0.61 [95%置信区间（CI）-1.86-0.63]}，更好的心理 HRQoL[1.77（95%CI 0.54-3.01)]和更低的症状负担[-2.38（95%CI -5.08-0.32)]。随着症状负担的增加，老年患者的身体 HRQoL 下降幅度大于年轻患者（β分别为-0.287 和-0.189，P 值为交互作用<.007）。对于心理 HRQoL，两个年龄组的下降幅度相似（β分别为-0.295 和-0.288，P=.847）。
与年轻患者相比，老年血液透析患者通常具有更好的心理 HRQoL 和（无统计学意义）更低的症状负担。随着症状负担的增加，他们的身体 HRQoL 下降得更快。
