Santos Paulo Roberto, Franco Sansigolo Kerr Lígia Regina
Postgraduate Program in Medical Sciences, Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil.
Rev Med Chil. 2008 Oct;136(10):1264-71. Epub 2009 Jan 15.
Amongst chronic diseases, end-stage renal disease (ESRD) deserves special attention in the context of health-related quality of life (HRQOL). ESRD affects quality of life more intensely than heart failure, diabetes, chronic lung disease, arthritis and cancer In addition, patients who perceive low HRQOL withdraw from dialysis treatment more commonly
To identify clinical and laboratory variables associated with health-related quality of life (HRQOL) in hemodialysis (HD) patients.
We included 174 chronic HD patients from a single unit aged 18 years and older who never received a kidney allograft and survived the first three months of treatment. We used the Khan index to assess comorbidity and the Medical Outcomes Study 36-Item Short Form Health Survey Questionnaire (SF-36) to measure HRQOL.
Amongst the eight domains of HRQOL, physical role had the lowest score (35.0+/-43.0) and social function the highest (64.3+/-27.7). In the multivariate analysis, age was associated with seven of eight domains, excepting bodily pain. Albumin was associated with five of eight domains. Time on dialysis, hemoglobin and calcium-phosphorus product were associated with physical function, bodily pain and vitality, respectively.
Age and albumin were the main variables associated with quality life, and the calcium-phosphorus product was associated with a strategic domain: vitality. Attention to albumin and ageing effects, control of the calcium-phosphorus product and improvement of physical conditioning are necessary to achieve better HRQOL.
在慢性疾病中,终末期肾病(ESRD)在健康相关生活质量(HRQOL)方面值得特别关注。ESRD对生活质量的影响比心力衰竭、糖尿病、慢性肺病、关节炎和癌症更为强烈。此外,认为HRQOL较低的患者更常退出透析治疗。
确定血液透析(HD)患者中与健康相关生活质量(HRQOL)相关的临床和实验室变量。
我们纳入了来自单一单位的174例年龄在18岁及以上的慢性HD患者,这些患者从未接受过肾移植且在治疗的前三个月存活。我们使用汗氏指数评估合并症,并使用医学结局研究36项简短健康调查问卷(SF - 36)来测量HRQOL。
在HRQOL的八个领域中,身体角色得分最低(35.0±43.0),社会功能得分最高(64.3±27.7)。在多变量分析中,年龄与八个领域中的七个相关,身体疼痛除外。白蛋白与八个领域中的五个相关。透析时间、血红蛋白和钙磷乘积分别与身体功能、身体疼痛和活力相关。
年龄和白蛋白是与生活质量相关的主要变量,钙磷乘积与一个关键领域:活力相关。关注白蛋白和衰老影响、控制钙磷乘积以及改善身体状况对于实现更好的HRQOL是必要的。