| Objective To investigate the quality of life (QoL) of maintenance hemodialysis (MHD) patients and analysis its influencing factors, for providing theoretical guidance to improve the QoL of patients.Methods MHD patients in the author’s hospital were recruited in this study. Collected clinical datas of patients like age, body mass index, cultural level, family income, primary disease, maintain dialysis duration, Kt/V, hemoglobin, serum albumin, cholesterol, high sensitive C reactive protein, pulmonary artery systolic pressure and so on. The pulmonary artery systolic pressure examined by echocardiography. The QoL of patients were assessed by MOS 36 item short form health survey (SF-36) Nutritional status of patients were evaluated by modified quantitative subjective global assessment (MQSGA). The patients were grouped respectively according to age, MQSGA score, primary disease, cultural level, family income, then compared with each other. Bonferroni analysis of variance, pearson correlation analysis and multiple linear stepwise regression analysis were performed to determine the effect of related factors on QoL scores.Results1. A total of 257 patients, their average age and dialysis vintage were 57.90±15.18 years and 34.83±12.62 months. The scores of all scales of SF-36 evaluation in MHD patients were relatively lower than that of general population as reported before.2. The research showed that BMI of MHD patients declined generally, and 94.94% of the MHD patients experienced various degrees of malnutrition assessed by the MQSGA method.3. Pearson correlation analysis revealed that physical component summary (PCS), mental component summary(MCS) and comprehensive SF-36 score of MHD patients were negatively correlated with age(r respectively was -0.396,-0.196,-0.337, all P<0.05). The patients were divided into four groups according to age, which respectively are 21-40 years old,41-60 years,61-80 years old,81 years old and above. Their PCS score decreased gradually with age, nevertheless, the MCS score was highest in the age group of 41-60, and the differences compared with other groups were statistically significant.4. Pearson correlation analysis also revealed that PCS score, MCS score and comprehensive SF-36 score of MHD patients were negatively correlated with MQSGA score (r respectively was 0.662,-0.486,-0.636, all P＜0.05). The patients were divided into four groups according to MQSGA score, which respectively are good nutrition, mild malnutrition, moderate malnutrition and severe malnutrition. The PCS score, MCS score and comprehensive SF-36 scores of patients with good nutrition were significantly higher than patients with moderate to severe malnutrition, and the differences were statistically significant.5. The score was lower in patients with diabetic nephropathy when compared with other patients. Univariate analysis of variance revealed that high SF-36 scores associated with higher education or income.6. Multivariate analysis indicated that PCS score and comprehensive SF-36 score of MHD patients were positively correlated with body mass index (BMI) and cholesterol (b respectively was 1.900,0.7661; 1.348, 0.57, all P<0.05), but negatively correlated with diabetic nephropathy, pulmonary artery systolic pressure and MQSGA score (b respectively was-2.514,-6.446,-2.343;-2.016,-4.395,-1.800, all P＜0.05). There was positive correlation between MCS score and income (b=2.113, P＜0.05), yet negative correlation between MCS score and MQSGA score(b=-1.285, P<0.05)Conclusion Compared with the general population, MHD patients own relatively poor QoL. Their primary diseases and nutritional status are probably the main influencing factors, in addition, age, cultural level, family income and pulmonary artery systolic pressure may also have certain effect on their QoL. |
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