Clinical Features And CKD-related Quality Of Life In Patients With Pre-dialysis

ObjectiveTo explore the differences quality of life in patients with chronic kidney disease1-4;To analyze the relationship between quality of life and clinical and laboratory tests of pre-dialysis patients with chronic kidney disease and its influencing factors;to analyze the relationship between quality of life and prognosis of patients with pre-dialysis chronic kidney disease.MethodsA retrospective cohort study was designed.Patients with pre-dialysis CKD were diagnosed and regularly followed up(?1 year)in the Department of Nephrology,XX Medical University from January 1,2011 to December 31,2014 were enrolled.we collected general patient information,laboratory indicators,primary diseases,and outcomes.Followed up to August 1,2018.According to the median of PCS and MCS,the patients with lower than the median score were classified as low group,and the scores higher than the median patients were attributed to high group.Comparing Clinical characteristics of the two groups patients.Kaplan-Meier and Cox single factor and multivariate proportional hazard models were used to analyze the relationship between quality of life and prognosis in patients with non-dialysis chronic kidney disease.Results(1)A total of 175 pre-dialysis CKD patients were enrolled,including 96 males(54.9)and79 females(45.1%).The age was(42.06±12.54)years,the average follow-up time was(60.11±.16.45)Month.The main primary diseases were: 75 cases(42.9%)with chronicglomerulonephritis,64 cases(36.6%)with nephrotic syndrome.(2)Comparison of baseline data: Compared with the PCS high group,the PCS low group group had higher education level,family annual income,serum albumin(Alb)and urea nitrogen(BUN)levels;MCS high group compared with MCS low group,the former Serum albumin(Alb)levels were lower,urea nitrogen(BUN),and lower serum calcium levels(Ca),the difference was statistically significant(P <0.05);Comparing the quality of life of patients with CKD1-4 stages,there were differences in emotional status scores(P=0.015)and MCS scores(p=0.018)in patients with CKD1-4.(3)Through single factor correlation analysis and multiple linear regression,we found that occupational status(p=0.041)was the influencing factor of PCS score,blood urea nitrogen(p=0.047)was the influencing factor of MCS score in pre-dialysis chronic kidney disease.(4).End point events: After(60.11±16.45)months of follow-up,a total of 33(18.86%)patients reached the end point event.Kaplan-Meier survival analysis showed no significant difference in MCS high group(Log RanK=0.069 p=0.301;Brelow=1.707 P=0.191)and disease progression in low-group patients.(5)Cox hazards model analysis: After adjusting for confounding factors,lower MCS score(HR0.953,95% CI 0.924-0.984,p= 0.003),hemoglobin(HR0.967,95% CI 0.937-0.997,p=0.033)and elevated serum uric acid(HR1.006,95% CI 1.001-1.011,P=0.026)were risk factors for disease progression in pre-dialysis patients with chronic kidney disease.ConclusionThere are differences in emotional status scores and MCS scores in CKD1-4 patients;age of onset,high-density lipoprotein,occupation status,annual household income,blood urea nitrogen,etc.are related to the quality of life of pre-dialysis chronic kidney disease,among which occupation status is pre-dialysis chronic kidney disease patients Independent influence factors of PCS score,urea was the independent influence factor of MCS score of non-dialysis chronic kidney disease;lower MCS score,hemoglobin and elevated serum uric acid were risk factors for disease progression in pre-dialysis patients with chronic kidney disease.