The Influence Of Hemodialysis Adequacy And Nutritional Status On The Quality Of Survival

Accumulation in vivo toxin of the patients with end-stage renal disease can cause metabolic disorder and a series of clinical symptoms. Hemodialysis is one of the main renal replacement therapy, and the purpose is to extend the survival time of the patients with end-stage renal disease, reduce mortality and improve patients' quality of survival. With hemodialysis technology and equipment continue to improve, dialysis patient surial rates gradually raised,so it appears very important for us to effectively improve the living quality of the patients with long-term hemodialysis We have conducted a research regarding the subject of the influence of hemodialysis adequacy and nutritional status on the quality of survival.Objective:to study the influence of hemodialysis adequacy and nutritional status on the quality of survival, guiding dialysis scheme to formulate and improvet, improving the long-term quality of survival of the maintenance hemodialysis patients.Methods:Thirty-one patients were chosen from the blood dialysis center of the First Hospital of Jilin University, and the selected patients must be a stable hemodialysis over three months. according to the difference of quality of life , we divide all patients into two groups with two level classification of survival, includingⅠgroup for the high quality for survival andⅡgroup for the low quality for survival ,and complete the collection of the relevant history. Through measuring the blood urea nitrogen concentration of each patient before dialysis and after. At the mine time we calculate the whole urea clearance (Kt/V), standard protein catabolic rate (nPCR) and time-average concentration of urea (TACurea) through applications of corresponding calculation formula.We should finish the measurement of plasma albumin, former albumin, cholesterol and blood serum creatinine before dialysis, and the simultaneous measurement of the human body index including height, weight, upper arm muscle circumference and triceps skin-fold. We use the subjeetive global assessment(SGA) to evaluate the nutritional status of patients through asking the patients about the relevant clinical symptoms. At the end, we need to have a full assessment of the maintenance hemodialysis patients on the dialysis adequacy and nutrition status. We use the SPSS17.0 statistics software package to processing the data. Experimental data were denoted by average±standard deviation( (x|-)±S), samples between the two groups were used t-test. And the count data among groups were used Chi-aquare test. The test standard was set by bilateralα=0.05,with P <0.05 as statistically significant.Results:1,Comparison between the different quality of survival in the two groups: Kt / V and nPCR in groupⅠwere higher than that in groupⅡ, and TACurea was lower than that in groupⅡ(P <0.05). 2,Comparison between the different quality of survival in the two groups: Alb, PA, CHO, MAC, TSF and MAMC in groupⅠwere higher than that in groupⅡ(P < 0.05). And there are no significant difference between serum creatinine and urea nitrogen(P >0.05). 3,31 patients were treated with SGA score: 20 cases of normal nutrition, accounting for 64.5%; 10 cases of mild to moderate malnutrition, accounting for 32.3%; 1 cases of severe malnutrition, accounting for 3.2%. And the comparison of malnutrition rate between the two groups, groupⅠwas lower than groupⅡ(P < 0.05). 4,Kt/V is positively correlated with nPCR,Alb,PA,CHO,MAMC(P < 0.05). And Kt/V is uncorrelated with TSF and MAC(P >0.05).Conclusion: 1,Hemodialysis adequacy is a factor which can affect the quality of survival. Keeping good hemodialysis adequacy will be help for improving survival quality. 2,There is a close relationship between nutritional status and the quality of hemodialysis patients survive, good nutrition is the important factor that can decide the quality of survive. 3,Kt/V is positively correlated with nPCR,Alb,PA,CHO,MAMC, it is uncorrelated with TSF and MAC. To sum up, it is proved that dialysis adequacy and nutrition status have significant influence on quality of survival for the maintenance hemodialysis patients. It wluld be help for the maintenance hemodialysis patients to improve the quality of survival if they can maintain good hemodialysis adequacy and nutrition status.