Quolity Of Life For Patients With Chronic Kidney Disease Stage 3-5 And Its Inflencing Factors

【Objective】To study the health relate quality of life and disease management of patients with non-dialysis chronic kidney disease stage3-5,as well as to explore the factors that affect the quality of life of these patients,in order to provide theoretical basis for disease management.【Methods】Patients with chronic kidney disease stage 3-5 before dialysis in our center from July 2019to December 2019 were enrolled in this study.General information on these patients was collected,including age,gender,family income,marital status,employment status,education background,etiology,blood pressure level as well as related laboratory indicators（hemoglobin（Hb）,serum creatinine（Cr）,estimated glomerular filtration rate（e GFR）,serum prealbumin（PA）,serum albumin（ALB）,serum iron（Fe）,blood phosphorus（P）,serum parathyroid hormone（PTH）,serum total cholesterol（TC）,serum total triglycerides（TG））.The health related quality of life was evaluated by the Kidney Related Quality of Life Scale(KDQOL^TM-36).SPSS24.0 software was used for statistical analysis of the data.The measurement data conforming to the normal distribution were expressed as mean±standard deviation（x±s）,and data not conforming to the normal distribution were express as the median（interquartile range）[M（P25,P75）].The comparison between two groups of data were analyzed by t-test（equal variance）and t’-test（unequal variance）;the comparison between multiple groups of data were analyzed by ANOVA and Kruscal Walis test.The count data were expressed as percentage（%）,and the chi-square test was used for comparison between groups.Linear regression analysis was adopted for analysis of effecting factors.P<0.05 was considered the difference to be statistical,and P<0.01 considered the difference to be statistically significant.【Result】1)Among 78 patients whose clinical data are valid,32（41.0%）of them were female,46（59.0%）of them were male,and the average age was 49.54±18.37 years old.The primary disease distribution was as follow:30（38.4%）cases of chronic glomerulonephritis,27（34.6%）cases of diabetic nephropathy,9（11.5%）cases of hypertensive nephropathy,3（3.8%）cases of obstructive nephropathy,and 2 cases of vasculitis associated nephropathy（2.6%）,1 case of interstitial nephropathy（1.3%）,and 6 cases of unknown etiology（7.7%）.2)In this study,The hemoglobin（Hb）level of the patients was 101.6±15.50g/L.There were 37patients（47.4%）with a history of primary hypertension.There were 42 patients（53.8%）with abnormal calcium and phosphorus metabolism.3)The quality of life scores of patients included in this study were as follow:PF 66.82±29.10,BP 56.78±24.31,RP 71.80±17.40,GH 57.10±13.42,VT 55.90±15.01,SF 67.83±14.20,MH 69.52±15.02,RE 61.40±13.90,MCS 65.20±13.45,PCS 63.80±13.50.4)There was no statistically significant difference in the overall quality of life between men and women,but the scores in bodily pain（BP）（P=0.027）and physical function（PF）（P=0.001）were statistically significant according to the inspection level of P<0.05.Physical function（PF）（P=0.014）and mental health（P=0.010）of different age groups were statistically significant.Role physical（RP）（P=0.002）,general health（GH）（P=0.045）,and social function（SF）（P=0.008）of different educational background were statistically significant.Role emotional（RE）（P=0.001）of patients with different marital status was statistically significant.Role physical（RP）of patients of different levels of hemoglobin（Hb）was statistically significant.Patients with diabetes gain lower scores in role physical（RP）（P=0.001）,physical function（PF）（P=0.020）and vitality（VT）（P=0.020）.By univariate analysis,young and high hemoglobin level had significant association with Physical Component Summary（PCS）.Male,employed,high hemoglobin level and primary disease as non-diabetes had significant association with Mental Component Summary（MCS）.6)Multiple linear regression analysis demonstrated that primary disease as diabetes mellitus,gender,age,hemoglobin level,and employment status were found to be most critical determinants of QOL for this population.【Conclusion】Chronic kidney disease affects the quality of life of patients and patients with CKD3-5gain worsen QOL scores compared with Chinese general population.The health-related factors mainly include gender,age,marital status,employment status,primary disease as diabetes,hemoglobin level（Hb）,and hematocrit（HCT）.Young male,highly educated,without diabetes,unmarried,and high hemoglobin levels（Hb）have a positive impact on the quality of life of patients.This study is to provide scientific basis for clinical psychological treatment of CKD patients.It is hoped that more and more attention will be paid to the quality of life of this group in order to help CKD patients to increase their self-consciousness and return to normal life.