高通量血液透析与血液透析滤过对老年透析病人生活质量的影响

Effect of high flux hemodialysis and hemodiafiltration on the quality of life in elderly patients receiving maintenance hemodialysis

目的 探讨高通量血液透析(HFHD)与血液透析滤过(HDF)对老年维持性血液透析(MHD)病人生活质量的影响。方法 采用横断面调查研究,收集病人一般临床资料并应用肾脏疾病生活质量简表(KDQOL-SF)对MHD病人的生活质量进行调查,经倾向性评分匹配法(PSM)均衡组间协变量后,比较HFHD与HDF病人生活质量的差异。结果 HDF组肾脏和透析相关生存质量(KDTA)量表的疾病负担(burden of kidney disease,BKD)得分和一般健康生存质量(SF-36)量表在生理功能、总体健康、活力方面的得分均高于HFHD组,差异有统计学意义(P<0.05)。结论 在老年MHD病人中,相较于HFHD,HDF引起的疾病负担较重,但也能改善病人的生理功能、总体健康状况及活力。

Objective To investigate the effects of hemodiafiltration(HDF) and high flux hemodialysis( HFHD) on the quality of life(QOL) in the elderly patients receiving maintenance hemodialysis(MHD).Methods A cross-sectional study was conducted in Blood Purification Center,Zhongda Hospital,Southeast University from January 2019 to December 2021,and the clinical data of all patients were collected.Kidney disease quality of life-short form(KDQOL-SF) was applied to assess the health-related quality of life(HRQL) of the patients.The efficacy and QOL were compared between the patients receiving HFHD and those receiving HDF after propensity score matching(PSM).Results There were significant differences in scores of burden of kidney disease in kidney disease-targeted areas(KDTA) and scores of physical functioning,general health,and vitality of 36-item health survey(SF-36)(P<0.05).Conclusions In elderly MHD patients,disease burden caused by HDF is heavier than HFHD,but HDF can improve QOL-related physiological functions,general health and vitality.