Jamain Al-Amin, Tan Jackson, Rahman Hanif Abdul
PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei Darussalam.
Ministry of Health, Bandar Seri Begawan, Brunei Darussalam.
Int Urol Nephrol. 2025 Mar 29. doi: 10.1007/s11255-025-04470-w.
End-stage kidney failure (ESKF) requires kidney replacement therapy (KRT), which has a significant effect on the quality of life (QoL) of patients. Globally, well-established treatment options for ESKF include HD, PD, and kidney transplantation. Each has a unique effect on a patient's QoL in terms of their physical, mental, and social health. The objective of this study was to evaluate and compare the QoL of patients undergoing PD and HD by utilizing the 36-item Short Form Health Survey (SF-36), EuroQoL-5-dimension (EQ-5D), and WHOQOL-BREF questionnaires.
We performed a comprehensive review and meta-analysis by identifying relevant research through the use of ScienceDirect, CINAHL, MEDLINE, and Google Scholar. These studies examined patients with ESKF who were undergoing either HD or PD and reported changes in QoL and biochemical characteristics. If heterogeneity was present, we calculated and pooled the standardized mean differences (SMDs) in QoL among modalities via a random effects model.
This analysis included twenty-five (25) studies that examined the QoL and biochemical characteristics of a total of 5,440 participants. Among these participants, 3465 (63.75%) were receiving HD, and 1975 (36.25%) were receiving PD. The QoL instruments assess a variety of effects. However, these studies demonstrate that PD consistently performs better than HD in multiple assessment components, including for burdens of kidney disease, general health, mental health, and emotional. Nevertheless, there was no significant difference in the QoL scores regarding cognitive ability, energy levels, physical health, patient satisfaction, psychology, social interaction, emotional well-being, sexual functioning, or sleeping patterns between these modalities.
The study's findings show that patients with PD have a higher QoL in comparison to those with HD. Despite reports of enhanced QoL among PD patients, their global prevalence remains relatively low. Therefore, healthcare professionals should prioritize the development and implementation of strategies for ESKF patients, considering PD as the primary treatment. The results suggest a trend favoring PD over HD in various aspects of QOL. However, the significant heterogeneity and the lower number of PD patients require careful interpretation of these findings.
终末期肾衰竭（ESKF）需要肾脏替代治疗（KRT），这对患者的生活质量（QoL）有重大影响。在全球范围内，ESKF成熟的治疗选择包括血液透析（HD）、腹膜透析（PD）和肾脏移植。就患者的身体、心理和社会健康而言，每种治疗方法对患者的生活质量都有独特的影响。本研究的目的是通过使用36项简短健康调查问卷（SF - 36）、欧洲五维健康量表（EQ - 5D）和世界卫生组织生活质量简表（WHOQOL - BREF）来评估和比较接受PD和HD治疗的患者的生活质量。
我们通过使用科学Direct、CINAHL、MEDLINE和谷歌学术搜索来识别相关研究，进行了全面的综述和荟萃分析。这些研究调查了接受HD或PD治疗的ESKF患者，并报告了生活质量和生化特征的变化。如果存在异质性，我们通过随机效应模型计算并汇总各治疗方式之间生活质量的标准化平均差异（SMD）。
该分析纳入了25项研究，这些研究共调查了5440名参与者的生活质量和生化特征。在这些参与者中，3465名（63.75%）接受HD治疗，1975名（36.25%）接受PD治疗。生活质量评估工具评估了多种影响。然而，这些研究表明，在多个评估指标上，包括肾病负担、总体健康、心理健康和情绪方面，PD始终比HD表现更好。然而，在认知能力、能量水平、身体健康、患者满意度、心理、社交互动、情绪健康、性功能或睡眠模式方面，这些治疗方式的生活质量得分没有显著差异。
研究结果表明，与接受HD治疗的患者相比，接受PD治疗的患者生活质量更高。尽管有报道称PD患者的生活质量有所提高，但其全球患病率仍然相对较低。因此，医疗保健专业人员应优先为ESKF患者制定和实施相关策略，将PD作为主要治疗方法。结果表明在生活质量的各个方面都有倾向于PD而非HD的趋势。然而，显著的异质性和较少的PD患者数量需要对这些结果进行谨慎解读。
