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改良肌酐指数与血液透析患者生活质量的相关性。

Association of the modified creatinine index with quality of life in haemodialysis patients.

机构信息

Department of Nursing, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.

Department of Cardiothoracic Intensive Care Unit, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.

出版信息

Br J Hosp Med (Lond). 2024 Sep 30;85(9):1-10. doi: 10.12968/hmed.2024.0298. Epub 2024 Sep 20.

Abstract

The evaluation of health-related quality of life in patients undergoing maintenance haemodialysis has garnered increasing attention. The modified creatinine index, a surrogate marker for muscle mass, has been linked to various clinical outcomes. However, the relationship between modified creatinine index and health-related quality of life in maintenance haemodialysis patients remains unclear. This study aims to elucidate the association between modified creatinine index and health-related quality of life in individuals receiving maintenance haemodialysis. This cross-sectional study included 217 maintenance haemodialysis patients. Health-related quality of life was assessed using the Kidney Disease Quality of Life Instrument. Collected data included general patient information, laboratory results, and haemodialysis-related parameters. The modified creatinine index was calculated based on gender, age, single-pool Kt/V (spKt/V), and pre-dialysis serum creatinine levels. Multiple linear regression models and smooth curve fitting were used to investigate the relationship between modified creatinine index and health-related quality of life. Subgroup analyses and interaction tests were performed to identify potential effect modifiers. The 217 maintenance haemodialysis patients had a mean age of 53.66±13.15 years and a median dialysis vintage of 39 (25-84) months; 120 (55.30%) were male. The mean health-related quality of life score was 55.76±10.33, and the mean modified creatinine index was 22.72±2.95 mg/kg/day. After adjusting for confounding factors, an increase in modified creatinine index was associated with an improvement in health-related quality of life (β=0.55, 95% CI: 0.04, 1.06, = 0.033). No nonlinear relationship was identified between modified creatinine index and health-related quality of life by smooth curve fitting. Subgroup and interaction analyses indicated that the relationship between modified creatinine index and health-related quality of life was stable and not significantly influenced by age, gender, dialysis vintage, diabetes status, or body mass index ( > 0.05). Modified creatinine index is positively correlated with health-related quality of life in maintenance haemodialysis patients, suggesting its potential utility in evaluating patient quality of life. Modified creatinine index could be clinically useful to improve the predictability of health-related quality of life in maintenance haemodialysis patients.

摘要

接受维持性血液透析的患者的健康相关生活质量评估受到越来越多的关注。改良的肌酐指数是肌肉量的替代标志物,与各种临床结果相关。然而,维持性血液透析患者的改良肌酐指数与健康相关生活质量之间的关系尚不清楚。本研究旨在阐明接受维持性血液透析个体的改良肌酐指数与健康相关生活质量之间的关联。

这项横断面研究纳入了 217 名接受维持性血液透析的患者。使用肾脏病生活质量量表评估健康相关生活质量。收集的数据包括一般患者信息、实验室结果和血液透析相关参数。改良的肌酐指数根据性别、年龄、单池 Kt/V(spKt/V)和透析前血清肌酐水平计算。使用多元线性回归模型和光滑曲线拟合来研究改良肌酐指数与健康相关生活质量之间的关系。进行亚组分析和交互检验以确定潜在的效应修饰剂。

217 名接受维持性血液透析的患者的平均年龄为 53.66±13.15 岁,中位透析龄为 39(25-84)个月;120 名(55.30%)为男性。健康相关生活质量评分的平均值为 55.76±10.33,改良的肌酐指数的平均值为 22.72±2.95mg/kg/day。调整混杂因素后,改良肌酐指数的增加与健康相关生活质量的改善相关(β=0.55,95%CI:0.04,1.06, = 0.033)。通过光滑曲线拟合未发现改良肌酐指数与健康相关生活质量之间存在非线性关系。亚组和交互分析表明,改良肌酐指数与健康相关生活质量之间的关系是稳定的,不受年龄、性别、透析龄、糖尿病状态或体重指数( > 0.05)的显著影响。

改良的肌酐指数与维持性血液透析患者的健康相关生活质量呈正相关,提示其在评估患者生活质量方面具有潜在的应用价值。改良肌酐指数可能在临床上有助于提高维持性血液透析患者健康相关生活质量的预测能力。

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