| Object iveThis cross-sectional study is to evaluate the quality of life of chronic kidney disease stage3-5non dialysis population and to analyse its’ potential factors. In addition, effect of chronic disease management of CKD is observed.MethodsThe subjects were those CKD stage3-5non-dialysis patients who regularly consulted in nephrology department of Guangdong Provincial Hospital of Chinese Medicine. Information on personal background, clinical results and state of nutrition was collected. Kidney Disease Quality of Life Instrument-Short Form (KDQOL-SF) was used to evaluate the patients’quality of life. KDQOL-SF scores were calculated, and8dimensions which reflected the physical and mental health were convered into two main catalogue: physical component summary (PCS) and mental component summary (MCS). Enrolled patients were divied into PCS/MCS high scores group and the low one. Differences of demographic background, different CKD stage, serum creatinine level, albuminuria level, different Chinses Medicine syndromes, SGA score, BMI index, serum albumin level and dimensions of KDTA between the high and low PCS/MCS groups were compared. Using the SPSS17.0software, measurement data was analyzed by t-test or non-parametric test, and the enumeration data was analyzed by chi-square test (α=0.05). Those factors with statistic differences then further analyzed by logistic regression analysis.Then, some of the patients were enrolled to recieve the intervention of chronic disease management. After one year, these patients re-filled the KDQOL-SF again. Change of quality of life was eveluated based on the differences between the KDQOL-SF before and after intervention.Results132cases of CKD stage3-5non-dialysis patients was included.The averaged scores of8dimensions which contained in the SF-36were all lower than the health people group in China (P<0.05). Non-dialysis patients in CKD stage3-5had higher MCS scores (55.26±18.23) than PCS scores (39.13±16.91).One of the three dimensions with the lowest scores were general health (32.15±18.43), burden of kidney disease (31.34±20.09) and sexual function (20.55±36.23)Univariate analysis showed that different Chinses Medicine syndromes (P=0.002), SGA score (P=0.008), serum albumin level (P=0.048), symptom or problems (P=0.002), effects of kidney disease on daily life (P=0.010), burden of kidney disease (P=0.000), work status (P=0.002), sleep (P=0.012) and social support (P=0.001) were related to the PCS. Meanwhile, age (P=0.024) sex (P=0.035), condition of medical insurance (P=0.003), symptom or problems (P=0.020), effects of kidney disease on daily life (P=0.021), burden of kidney disease (P=0.000), work status (P=0.016), quality of social interaction (P=0.047) and social support (P=0.007) were related to the MCS.Logistic regression analysis showed that effects of kidney disease on daily life (OR:1.047), burden of kidney disease (OR:1.030) and social support (OR:1.013) were the independent factors of PCS. Sex (OR:0.339), condition of medical insurance (OR:3.368) and burden of kidney disease (OR:1.049) were the independent factors of MCS.31cases were enrolled for the intervention of chronic disease management. During the follow-up period,1cases was excluded for the initiate of renal replacement therapy. There was no statistic differences of serum creatinine level(P=0.964), albuminuria level(P=0.624) and serum albumin level (P=0.207) between the former and1year after data. As to the KDQOL-SF, scores of physical functioning (P=0.000), role limitations caused by physical health problems (P=0.001), body problems (P=0.038), role limitations caused by emotional health problems (P=0.007), emotional well-being (P=0.001), burden of kidney disease (P=0.002), patient satisfaction (P=0.017) were improved after chronic disease management intervention.Conclusion The quality of life of CKD stage3-5non-dialysis patients was worse than healthy population in China. Their physical health statis was worse than the mental health. The independent factors of quality of life in these patients group were female, insufficient social support, lack of medical insurance cover, deeply affected by the kideny disease, with heavy daily life bureden. |
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