Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan.
Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, Japan.
BMC Nephrol. 2024 Oct 18;25(1):362. doi: 10.1186/s12882-024-03818-1.
In chronic kidney disease (CKD), the durability of patient adherence to fluid and dietary restrictions may depend on the degree to which they have hope that they will enjoy life. Previous cross-sectional studies have shown that higher hope was associated with lower distress from fluid and dietary restrictions and better adherence in the short term. In this study, we aimed to examine the long-term relationship of hope with distress from fluid and dietary restrictions.
This prospective observational cohort study included 444 patients with CKD undergoing dialysis in one of five Japanese nephrology centers. Hope as a predictor was measured using an 18-item health-related hope scale. Outcomes were two-item measures of distress from fluid and dietary intake restrictions using the Japanese version of the Kidney Disease Quality of Life Short Form, Version 1.3 (higher scores indicate lower levels of distress). Multivariate linear mixed models were used to estimate the association of baseline health-related hope with distress from fluid and dietary restrictions at baseline and follow-up.
The mean age of the participants was 67 years, and 31.1% of them were females. In total, 124, 98, and 222 had non-dialysis CKD, peritoneal dialysis, and hemodialysis, respectively. Higher levels of baseline health-related hope were associated with lower levels of distress from fluid restriction after one year (per 10-point increase, 2.6 points (95% confidence interval, 1.0 to 4.1)); whereas the baseline score was not associated with the distress from fluid restriction at 2 years. Similarly, higher levels of baseline health-related hope were associated with lower levels of distress from dietary restriction after one year (per 10-point increase, 2.0 points (95% confidence interval, 0.3 to 3.6)); whereas the baseline score was not associated with the distress from dietary restriction at 2 years.
Health-related hope, regardless of depression, can potentially mitigate long-term distress from fluid and dietary restrictions in patients with a wide range of CKD severities.
UMIN000054710.
在慢性肾脏病（CKD）中，患者对液体和饮食限制的坚持程度可能取决于他们对享受生活的希望程度。先前的横断面研究表明，较高的希望与短期内液体和饮食限制的痛苦减轻以及更好的依从性相关。在这项研究中，我们旨在检查希望与液体和饮食限制的痛苦之间的长期关系。
这项前瞻性观察队列研究纳入了 5 家日本肾病中心的 444 名接受透析治疗的 CKD 患者。使用 18 项与健康相关的希望量表来衡量希望作为预测指标。结果使用日本版肾脏病生活质量简表（Kidney Disease Quality of Life Short Form，Version 1.3）的两个项目衡量液体和饮食摄入限制的痛苦程度（得分越高表示痛苦程度越低）。使用多变量线性混合模型来估计基线健康相关希望与基线和随访时液体和饮食限制的痛苦之间的关联。
参与者的平均年龄为 67 岁，31.1%为女性。总共，124、98 和 222 例分别为非透析性 CKD、腹膜透析和血液透析患者。基线时健康相关希望水平较高与一年后液体限制的痛苦程度较低相关（每增加 10 分，痛苦程度降低 2.6 分（95%置信区间，1.0 至 4.1））；而基线评分与两年后的液体限制痛苦无关。同样，基线时健康相关希望水平较高与一年后饮食限制的痛苦程度较低相关（每增加 10 分，痛苦程度降低 2.0 分（95%置信区间，0.3 至 3.6））；而基线评分与两年后的饮食限制痛苦无关。
无论是否存在抑郁，与健康相关的希望都可能减轻各种 CKD 严重程度患者长期液体和饮食限制的痛苦。
UMIN000054710。
