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血液透析中的透析龄与症状负担:一项综合分析

Dialysis Vintage and Symptom Burden in Hemodialysis: A Comprehensive Analysis.

作者信息

Yan Shanshan, Wang Ya, Li Zhenzhen, Wang Duo, Yao Dongfang

机构信息

Department of Nephrology, Fourth Medical Center of Chinese PLA General Hospital, Beijing, China.

Department of Emergency Medicine, Fourth Medical Center of Chinese PLA General Hospital Beijing, Beijing, China.

出版信息

Nurs Health Sci. 2025 Sep;27(3):e70226. doi: 10.1111/nhs.70226.

Abstract

End-stage renal disease (ESRD) requires lifelong maintenance hemodialysis (MHD), and patients commonly experience a high symptom burden that affects their quality of life. This study explores the impact of dialysis vintage on symptom burden and quality of life in ESRD patients undergoing MHD. Our cross-sectional study of 213 Chinese hemodialysis patients found that symptom burden tended to increase with longer dialysis duration (Dialysis Symptom Index score from < 1 to > 10 years, p = 0.084), while urine output (p = 0.032) and Kt/V (p = 0.004) significantly decreased. Interestingly, quality of life improved across multiple domains as dialysis duration increased, including Kidney Disease Targeted Areas (KDTA) (p = 0.005), Symptom/Problem List (SPL) (p < 0.001), Effects of Kidney Disease (EKD) (p = 0.004), and Burden of Kidney Disease (BKD) (p < 0.001). These findings suggest that longer dialysis is associated with greater symptoms but also notable improvements in certain quality of life aspects. Personalized care is essential to address the evolving needs of long-term MHD patients and enhance their well-being.

摘要

终末期肾病(ESRD)需要终身维持性血液透析(MHD),患者通常承受着较高的症状负担,这会影响他们的生活质量。本研究探讨透析龄对接受MHD的ESRD患者症状负担和生活质量的影响。我们对213名中国血液透析患者进行的横断面研究发现,症状负担倾向于随着透析时间的延长而增加(透析症状指数评分从<1年至>10年,p = 0.084),而尿量(p = 0.032)和Kt/V(p = 0.004)显著降低。有趣的是,随着透析时间的增加,多个领域的生活质量都有所改善,包括肾脏病靶向领域(KDTA)(p = 0.005)、症状/问题清单(SPL)(p < 0.001)、肾脏病影响(EKD)(p = 0.004)和肾脏病负担(BKD)(p < 0.001)。这些发现表明,更长时间的透析与更多症状相关,但在某些生活质量方面也有显著改善。个性化护理对于满足长期MHD患者不断变化的需求和提高他们的幸福感至关重要。

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