Quality of life in peritoneal dialysis patients: Decline over time and association with clinical outcomes
Quality of life in peritoneal dialysis patients: Decline over time and association with clinical outcomes
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DOI：
10.1046/j.1523-1755.2002.00096.x
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发表时间：
2002-01-01
影响因子：
19.6
通讯作者：
Edmunds, ME
中科院分区：
文献类型：
--
作者：
Bakewell, AB;Higgins, RM;Edmunds, ME
背景：生活质量(QOL)作为衡量治疗结果的重要指标越来越受到人们的重视。这项研究的目的是确定哪些关键因素影响生活质量，生活质量的哪些方面随时间而变化，以及生活质量的测量是否与腹膜透析(PD)人群的临床结局相关。我们回顾了88名患者(占我们PD人口的70%)参加了关于透析充分性、营养和生活质量的纵向研究的结果。样本包括印度亚裔[N=35(糖尿病N=18)]和欧洲白人[N=53(糖尿病N=18)]血统。在注册时(在PD上3个月)记录人口统计数据。在登记时，每隔6个月记录透析充分性、营养状况、生活质量(使用KDQOL-SF(TM)量表)、住院情况、PD感染和治疗方式的改变。男性、亚裔和主观全球评估所衡量的营养状况差是与总体生活质量得分(身体健康、心理健康、肾脏疾病问题、患者满意度)独立相关的最显著特征。在测量的19个健康领域中，共病、肾脏置换月数、社会剥夺和血清白蛋白与部分相关。在为期两年的研究期间，生活质量稳步下降。最显著的变化是一般健康症状/问题、肾脏疾病负担、情绪幸福感和患者满意度。住院人数增加与较差的生活质量相关。帕金森病患者的生活质量随着时间的推移而下降。在亚洲和男性患者中，生活质量的某些方面尤其差。这项研究表明，有必要进行进一步的研究，以确定旨在增强情绪和社会支持的干预措施的效果。
Background, Quality of life (QoL) is increasingly well recognized as an important measure of treatment outcome. The aim of this study was to determine which key factors affect QoL, which aspects of QoL change over time, and if measurements of QoL were associated with clinical outcome in our peritoneal dialysis (PD) population.Methods. The results of 88 patients (70% of our PD population) enrolled in longitudinal studies of dialysis adequacy, nutrition, and quality of life were reviewed. The sample comprised Indo-Asian [N = 35 (diabetic N = 18)], and white Europeans [N = 53 (diabetic N = 18)] heritage. At enrollment (>3 months on PD) demographic data was recorded. At enrollment, and six-month intervals, the dialysis adequacy, nutritional status, QoL (using the KDQOL-SF (TM) instrument), hospital admissions, PD infections, and changes in treatment modality were recorded.Results. Male gender, Asian ethnicity, and poor nutritional status as measured by Subjective Global Assessment were the most significant characteristics independently associated with worse overall QoL dimension scores (physical health, mental health, kidney disease issues, patient satisfaction). Comorbidity, months of renal replacement, social deprivation and serum albumin were related to some of the 19 health domains measured. QoL declined steadily during the two-year study period. The most significant changes were for the items general health symptoms/problems, burden of kidney disease, emotional wellbeing, and patient satisfaction. Increased hospital admissions were associated with a worse QoL.Conclusions. Quality of life declines in patients on PD over time. Certain aspects of QoL are especially poor in Asian and male patients. This study suggests that further research is necessary to determine the effects of interventions directed at enhancing emotional and social support.