| Objective:To study the survival status of maintenance hemodialysis(MHD)patients in the blood purification center of our hospital,evaluate the quality of life,and analyze the influencing factors to provide a scientific basis for improving the quality of life of the patients.Method:Using the KDQOL-SFTM1.3 scale to conduct a questionnaire survey on patients undergoing maintenance hemodialysis in the Blood Purification Center of the First Affiliated Hospital of Nanchang University from July 2017 to August 2017,at the same time,record the demographic characteristic and general conditions of the patients,collect the relevant clinical and hemodialysis indexes,evaluate the quality of life of patients,analyze the influencing factors.Result:1.A total of 296 cases of MHD were included in this study,including 178 males and 118 females,the male to female ratio was 1.51:1,the average age was 59.27 + 14.47 years old,and the average dialysis period were 3.58 + 3.45 years.The first three primary diseases were chronic glomerulonephritis,diabetic nephropathy and hypertensive nephropathy,while in the elderly MHD patients,secondary renal disease caused by diabetes or hypertension was higher.2.The standard-reaching rate of serum calcium(Ca),serum phosphorus(P),calcium-phosphorus product,and intact parathyroid hormone(i PTH)in MHD patients was 44.2%,48.0%,74.9%,and 27.4%,the ratio of the four items reaching the standard was 10.5%,The standard-reaching rate of hemoglobin(Hb),albumin(Alb),predialysis systolic blood pressure(SBP),interdialytic weight gain/dry weight(IWG/DW)and urea scavenging index(Kt/V)was 26%,83.3%,87.5%,71.9% and 56.8% respectively.3.The total score of general health quality of life(SF-36)of MHD patients was 51.45 + 17.62,among which the physical component summary(PCS)score was 51.26 + 20.24,and mental component summary(MCS)score was 51.64 + 17.29,and the total score of kidney disease targeted areas(KDTA)was 57.07 + 10.40.4.Factors affecting the score of general health quality of life(SF-36)of MHD patients were: age,albumin,blood flow,whether the primary disease was diabetic nephropathy or not,the course of disease before dialysis,P,calcium-phosphorus product,among them age(B=-0.221,P<0.001),blood flow(B=0.161,P=0.005),albumin(B=0.134,P=0.024)were independent influencing factors;Factors affecting the score of kidney disease targeted areas(KDTA)of MHD patients were: age,whether the primary disease was diabetic nephropathy or not,blood flow,albumin,the course of disease before dialysis,education level,calcium-phosphorus product,P,i PTH,among them age(B=-0.320,P)<0.001),whether the primary disease was diabetic nephropathy or not(B=-0.166,P=0.003),blood flow(B=0.127,P=0.022)were independent factors.Conclusion:1.In this study,the quality of life score of MHD patients was improved compared with similar study in the early stage in China,the result was close to that of the United States group,but there was still a big gap between them compared with the Japanese group.2.There are many factors affecting the quality of life score of MHD patients,the management of chronic kidney disease should be strengthened for these factors,and make individualized treatment plans to improve the quality of life of patients.3.The quality of life score of MHD patients with primary disease of diabetic nephropathy was relatively low,we should strengthen the cooperation of multidisciplinary,focus on prevention and active treatment of primary diseases,and delay the occurrence and development of complications including kidney. |
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