Quality Of Life In End-stage Renal Disease Patients And Related Factors

Objective:With chronic kidney disease (CKD) progression, some CKD deteriorate into the end-stage renal disease (ESRD) eventually. Renal replacement therapy is important treatment method of ESRD. Due to improvement of technology and quality of renal replacement, the survival duration of ESRD patients has increased. But increasing of survival duration is not considered good quality of life (QOL). Physicians and Patients' family members pay more attention to QOL of ESRD patients. Improving the survival rate and increasing QOL of ESRD patient have be regarded as the targets of renal replacement therapy. Therefore, a multi-center research was conducted to investigate and compare the QOL in different characteristics of ESRD patients, and analyze factors related to QOL in these patients.Methods:1. Subjects and dataPatients according to the definition of CKD5from K/DOQI guide made by American kidney foundation (NKF) were recruited in First Affiliated Hospital Kunming Medical College, Yunnan kidney disease hospital and Chuxiong people's hospital. The QOL of patients was evaluated using KDQOL-SFTM1.2questionnaires and recorded their demographic and clinical characteristics simultaneously. During March2010to December2011. a total of318QOL questionnaires of ESRD patients were collected. and obtained260simultaneous clinical characteristics of these patients.2. Groups According to the clinical data, cases were divided into three groups:1. Non dialysis group (n=108), new ESRD patients had not received renal replacement therapy;2. Dialysis group (n=160), patients had received hemodialysis for three months or more;3. Renal transplantation group (n=50), patients had received renal transplantation for three months or more.Results:1. Comparison of tree groupsQOL of renal transplantation group was significantly higher than these of non dialysis group and dialysis group in the SF-36including PF, RP, Pain, GH, EWB, RE, SocF, Energ and the KDTA including SPL, EKD, BKD, WS, Sex F, Sleep; QOL of dialysis group was significantly higher than these of non dialysis group in PF, Pain, SPL, EKD, WS, Sleep.2. Demographic data and QOLStatistical analysis showed some significant differences in QOL of subgroups from demographic data.1). Non dialysis group:the SF-36was significant different in subgroups of age and occupation respectively; the KDTA was significant different in subgroups of occupation.2). Dialysis group:the SF-36was significant different in subgroups of nation, occupation, level of education and medical payment respectively; the KDTA was significant different in subgroups of occupation, level of education, individual income level and medical payment respectively.3). Renal transplantation group:the SF-36was significant different in subgroups of marriage state, occupation and individual income level respectively; the KDTA was significant different in subgroups of marriage state, occupation and individual income level respectively.3. Clinical indicators and QOLPearson correlation analysis:In non dialysis group, SF-36and KDTA scores were positively correlated with hemoglobin (r=0.24, P=<0.05/r0.20. P <0.05):In dialysis group, SF-36and KDTA scores were not correlated with hemoglobin, serum albumin and serum creatinine (p>0.05); In renal transplantation group, SF-36scores were negatively correlated to serum creatinine (r=-0.36, P<0.05).Conclusion:To some extent of improving QOL of ESRD patients, renal transplantation and hemodialysis are effective methods of treatment of ESRD, and renal transplantation would be the best treatment. Social demographic and clinical data on patients with ESRD have different influences or relate on QOL. The statistic results showed some significant:In the non dialysis group, ESRD Patients with higher hemoglobin had higher SF-36and KDTA scores, and in the Renal transplantation group, ESRD Patients with lower serum creatinine had higher SF-36scores.