| Objective: To evaluate the quality of life(QOL)of hemodialysis patients(maintenance hemodialysis,MHD)in Hefei,to analyze the factors that affect the patients' QOL,and to provide the basic knowledge for improvement of patients' QOL in the future.Methods: A questionnaire survey was conducted by using the KDQOL-SF version 1.3self-administered questionnaire in patients with maintenance hemodialysis at the blood purification center of 8 hospitals in Hefei from September 2015 to 2016.The patients' general data(including age,education level,occupation,household income per capita,primary disease,the Charlson Comorbidity Index,handgrip strength,duration of dialysis,clinical treatment,etc.)and clinical biochemical indicators were collected to evaluate MHD patients' health-related QOL and to analyze the related factors.Results: 1.In this survey,500 questionnaires were distributed and 425 valid questionnaires were collected.The effective response rate was 85.3%.There were 279 males and 146 females with male-female ratio of 1.91:1.The average age of patients was 50.17±13.76 years,and the average duration of dialysis was 52.87±52 month.2.In the MHD patients,the first three primary disease were glomerulonephritis(43.8%),hypertensive nephropathy(22.6%),and diabetic nephropathy(13.4%).Among them,no difference was found between male and female patients in the primary cause of the composition.And in the age group,compared with that of the young group(?45 years),the proportion of hypertensive nephropathy and diabetic nephropathy was significantly increased in the middle-aged group(46-60 years)and the elderly group(3 61 years)(22.3%,35.0% vs 14.6% and 15.1%,30.0% vs 1.3%,respectively).3.In the MHD patients,the average level of hemoglobin(Hb)was 156.39±89.96 g/L,and the perentage of patients with Hb3110g/L was 63.41%.The average level of serum calcium(Ca)was 2.24±0.24 mmol / L,the success rate of Ca was 63.36%.The average level of serum phosphorus(P)was 1.7±10.52 mmol / L,the sussess rate of P was 27.20%.The average level of Ca*P product was 47.78±15.46mg2/dl2,the success rate was73.33%.The average level of intact parathyroid hormones was 497.99±537.22 ng / L,the success rate of i PTH was 47.99%.4.Among 425 cases of MHD patients with clinical treatment,the rate of iron use was28%,the rate of folic acid use was 29.2%,and the rate of erythropoietin utilization use was 91.3%,with a average dosage of 8286.18±3243.37u/week;utilization rate of calcium carbonate was 42.4%,utilization rate of lanthanum carbonate or sevelamer hydrochlorideuse was 2.9%,and utilization rate of calcitriol soft capsules or alfacalcidyl was 45.5%.The proportion of parathyroidectomy was 5.6%.5.In this study,patients scores in BKD,WS,Se F,RP,GH and RE were low(less than50).The average KDTA level was 60.70±13.07,the average SF-36 level was55.51±18.75,the average MCS level was 57.21±21.94,and the average PCS level was53.81±18.71.6.The male patients scores were significantly higer in female patients in KDTA,SF-36,PCS,MCS and multiple branch areas(P<0.05).Overall,the QOL of male patients was better than females.7.Spearman correlation analysis showed that there was a negative correlation between age and Se F,Sleep,PF and PCS(P <0.05),a positive correlation between ultrafiltration volume and PF,PCS(P <0.05),and a positive correlation between handgrip strength and KDTA,SPL,(P <0.05).There was a correlation between the duration dialysis and the levels of Se F,SF-36,RP and MCS(P <0.05).The educational level and the per capita annual income of the patients were also correlation with KDTA,SF-36,MCS,PCS and multiple branches(P <0.05).There was a negative correlation between the Charson Comorbidity Index(CCI)and the SF-36,MCS,PCS and multiple branches(P<0.05).8.The results of variance analysis showed that the patients with primary diabetic nephropathy had slightly higher scores than those with hypertensive nephropathy in SF-36(P <0.05),and higher than those with primary glomerulonephritis and hypertensive nephropathyin PCS(P <0.05).The farmer patients scores were lower than on the job or retired in the KDTA,SF-36,MCS and multiple branches.The scores of township workers medical insurance group patients were higher than those of the new rural cooperative medical insurance group in KDTA,SF-36,MCS and various branches(P <0.05),and higher than the basic medical insurance group of urban residents in BKD,WS,SF-36,MH and MCS various branches(P <0.05).9.Multiple linear regression analysis showed that the level of education was positively correlated with KDTA,SF-36,MCS and PCS in MHD patients,CCI was negatively correlated with KDTA,SF-36,MCS and PCS,the age was positively correlated with KDTA and MCS scores,gender was negatively correlated with SF-36 and PCS scores,and level of serum albumin was positively correlated with SF-36 and PCS scores.Conclusion: 1.In this study,the health-related quality of life of MHD patients was still low and it was necessary to improve the quality of life of patients in the future as well as the long-term survival of patients.2.The QOL of male in the field of the comprehensive indicators and multiple branches were significantly higher than that of the female.And the age also had some impact on the QOL of patients.3.There was a correlation between the degree of education and and the Charson Comorbidity Index(CCI)and the QOL of MHD patients. |
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