Personalized Diet Intervention On The Quality Of Blood Dialysis Patients Survive

Objective The objective of this study was to assess the health-related quality of life(HRQoL) of maintenance haemodialysis(MHD) patients, as well as to analyze its influence factors, and to evaluate the effect of diet intervention on HRQoL in HD patients.Methods One hundred and four MHD patients were included. HRQoL were investigated by using short-form36Health Survey Questionnaire (SF-36). This data were compared with control group(n=86) from general population and analyzed the effects of the variables including gender, age, education level, marital status, primary disease, dialysis vintage on SF-36scale scores of HD patients. Through formulating individualized recipe and promoting the knowledge of nutrition,99MHD patients received diet intervention for6months. Their nutritional status and quality of life were assessed by using malnutrition-inflammation score (MIS) and SF-36, respectively before and after the intervention.Results104HD patient with SF-36scores were60.9±18.0, and the mental component summary(MCS) scores(68.3±21.8) were higher than physical component summary (PCS)(53.5±19.5). There were totally19.2%of HD patients with PCS<34and16.3%of HD patients with MCS≤42. It is worth noticing that there are9.6%of HD patients both had the critical score PCS<34and MCS≤42. Except the role emotional(RE) and mental health(MH), the HRQoL in HD patients was lower than the control group from general population in most HRQoL domains, such as physical function(PF), role physical(RP), bodily pain(BP), general health(GH), vitality(VT), social function(SF), physical component summary(PCS), mental component summary(MCS)(P<0.05).There were significant differences in HRQoL between male and female, also between two age groups, four education level groups, three marital status groups and between four dialysis vintage groups(P<0.05). Better HRQoL was revealed in the patients18～45years old, males, patients with higher education level, single patients and in the patients on MHD less than10year(P<0.05). There were significant correlation between PCS scores and age, sex, marital status, primary disease(P<0.05). Age was the only statistically significant predicator of PCS and MCS(P<0.05).The MIS score significantly decreased after diet intervention(5.30±2.38vs. 5.94±2.57)(P<0.05). There were24.2%of the HD patients with the critical score MIS>7.5before diet intervention and20.2%after diet intervention. Dietary intervention significantly increased the body mass index(BMI)、serum albumin(ALB) and serum transferrin(TRF) at6months (24.66±4.66kg/m2,39.07±3.06g/L,225.96±47.59mg/dL, respectively) compared with baseline (24.43±4.90kg/m2,38.41±3.48g/L,215.06±50.20mg/dL respectively)(P<0.05). According to SF-36, the rating-dimension scores elevated except social function(SF) and role emotion(RE)(P<0.05). There were10.1%of the HD patients had the critical score PCS<34+MCS≤42(20.2%of HD patients with PCS<34, and15.2%with MCS<42) before diet intervention. Through the diet intervention, it can be seen that5.1%of the HD patients had the critical score PCS<34+MCS≤42(8.1%of HD patients with PCS<34, and6.1%with MCS≤42).Conclusion The HRQoL of HD patients is lower than in the control group from general population. The HRQol was lower in the elderly, female, low educational level, widows and patients dialysis over ten years. Diet intervention can significantly improve the quality of life of patients undergoing haemodialysis, and improve the prognosis of the MHD patient.