65岁以上终末期肾病(ESRD)患者的健康相关生活质量(HRQOL)

P Rebollo, F Ortega, J M Baltar, C Díaz-Corte, R A Navascués, M Naves, A Ureña, X Badía, F Alvarez-Ude, J Alvarez-Grande
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引用次数: 120

摘要

目的:本研究的目的是评估本地区接受肾脏替代治疗(RRT)的老年患者的健康相关生活质量(HRQOL),并确定影响其的社会人口统计学和临床变量。我们也试图比较移植患者的HRQOL与慢性血液透析患者的HRQOL。设计:横断面研究。单位:医院肾内科。患者:所有来自本地区10个血液透析中心中的9个,年龄65岁或以上,接受RRT(慢性血液透析和肾移植)至少三个月,无认知问题的患者均被纳入研究。样本包括124名患者。干预措施:这些患者使用两份通用HRQOL问卷进行结构化访谈:疾病影响概况和SF-36健康调查。还收集了Karnofsky量表、共病指数、社会人口统计学和临床数据。结果:中位年龄71岁(65 ~ 75岁);55.6%的患者为男性;移植患者占19.8%,血液透析患者占80.2%(仅2%在肾移植等待名单上);69.2%为中低社会经济水平,52.9%为基础教育,10.6%为独居。移植患者的HRQOL高于血液透析患者。女性的HRQOL低于男性。较高的经济水平、较高的受教育程度、较高的Karnofsky绩效量表和较低的共病指数得分与较高的HRQOL相关。结论:与血液透析患者相比,老年移植患者HRQOL较好,是建议老年患者肾移植的重要原因。经济和教育水平、功能状况和合并症是影响这些患者HRQOL的变量。
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Health-related quality of life (HRQOL) in end stage renal disease (ESRD) patients over 65 years.

Objectives: The aim of the study was to assess Health Related Quality of Life (HRQOL) of elderly patients on renal replacement therapy (RRT) of our region, and to identify socio-demographic and clinical variables which influence it. We also attempted to compare HRQOL of transplant patients, with that of chronic hemodialysis patients.

Design: Cross-sectional study.

Setting: Institutional Hospital Nephrology Unit.

Patients: All patients from 9 of the 10 hemodialysis centres in our region, aged 65 years or more, who had been on RRT (chronic hemodialysis and kidney transplantation) for at least three months, showing no cognitive problems, were included. The sample included 124 patients.

Interventions: These patients participated in a structured interview using two generic HRQOL questionnaires: Sickness Impact Profile and SF-36 Health Survey. Karnofsky Scale, Comorbidity Index, socio-demographic and clinical data, were also collected.

Results: The median age was 71 years (range 65-75); 55.6% of the patients were male; 19.8% of the sample were transplant patients and 80.2%, hemodialysis patients (only 2% on renal transplant waiting list); 69.2% had a low-intermediate socio-economic level, 52.9% had elementary studies, and 10.6% lived alone. Transplant patients had higher HRQOL than hemodialysis patients. Women had lower HRQOL than men. A higher economic level, higher educational level, higher Karnofsky Performance Scale, and lower Comorbidity Index score, were associated with higher HRQOL.

Conclusions: The good HRQOL of elderly transplant patients, in comparison with hemodialysis patients, is an important reason for advising kidney transplants in elderly patients. Economic and educational levels, functional status and comorbidity are variables which influence the HRQOL of these patients.

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