Kvalitet života povezan sa zdravljem bolesnika koji se leče hemodijalizom
Sažetak
Uvоd/Cilj. Hronična bubrežna bolest danas je sve više zastupljena širom sveta. Kvalitet života povezan sa zdravljem (HRQoL) predstavlja koristan pokazatelj u populacijama obolelih od hroničnih bolesti kao što je hronična bubrežna bolest, pošto može poslužiti kao pouzdan prediktor smrtnog ishoda i hospitalizacije. Cilj ove studije bio je da se ispita kvalitet života povezan sa zdravljem populacije obolelih od terminalne bubrežne insuficijencije koji se leče hroničnom hemodijalizom (HD) i da se uporedi sa populacijom obolelih od hipertenzije (HTA) i populacijom naizgled zdravih osoba iste starosne dobi i polne strukture (C). Меtоdе. Studijom je obuhvaćeno ukupno 224 ispitanika starijih od 18 godina, oba pola: 67 u HD grupi, 78 u HTA grupi i 79 u C grupi. HRQoL je procenjivan u svim grupama korišćenjem 15-D standardizovanog upitnika. Rеzultаti. Ispitanici iz HD grupe imali su značajno više obrazovanje od ostale dve grupe. U HD grupi bilo je značajno manje zaposlenih (9%), a značajno više penzionera (67,2%). Grupe se nisu razlikovale u pogledu prosečnog mesečnog prihoda i bračnog stanja. Bolesnici u HD grupi imali su značajno niži ukupni HRQoL skor u poređenju sa ostalim grupama (0,78 ± 0,16 vs. 0,89 ± 0,10 u HTA i 0,95 ± 0,06 u C grupi), a takođe i niže specifične skorove u skoro svim preostalim aspektima kvaliteta života, osim u domenu govora, jela i mentalne funkcije, gde nije bilo razlike između grupa. Bolesnici iz HD grupe su zabeležili značajno niže skorove u odnosu na HTA grupu u sledećim domenima: pokretljivost, vid, disanje, spavanje, uobičajene aktivnosti, nelagodnost i simptomi, depresija, vitalnost i seksualna aktivnost, a slične u domenima: sluh, pražnjenje i duševna patnja. U HTA grupi zabeleženi su značajno niži skorovi u odnosu na C grupu u osam domena (sluh, spavanje, pražnjenje, uobičajene aktivnosti, nelagodnost i simptomi, depresija, duševna patnja i vitalnost, a u četiri domena rezultati su bili slični (pokretljivost, vid, disanje, seksualna aktivnost). Zаklјučаk. Obe ispitivane hronične bolesti dovode do smanjenja kvaliteta života povezanog sa zdravljem, s tim da je smanjenje značajno intenzivnije u slučaju hemodijalize nego u slučaju hipertenzije. S obzirom na povezanost depresije i ostalih merila kvaliteta života, lečenje depresije bi moglo biti korisno za poboljšanje kvaliteta života bolesnika na hemodijalizi.
Reference
Testa MA, Simonson DC. Assesment of quality-of-life outcomes. N Engl J Med 1996; 334(13): 835−40.
Vasiljevic N, Ralevic S, Marinkovic J, Kocev N, Maksimovic M, Sbu-tega-Milosevic G, et al. The assessment of health-related quality of life in relation to the body mass index value in the urban population of Belgrade. Health Qual Life Outcomes 2008; 6(1): 106−12.
Vlajinac H, Marinkovic J, Tanaskovic S, Kocev N, Radak D, Davi-dovic D, et al. Quality of life after peripheral bypass surgery: A 1 year follow-up. Wien Klin Wochenschr 2015; 127(5−6): 210−7.
Alanne S, Roine RP, Räsänen P, Vainiola T, Sintonen H. Estimat-ing the minimum important change in the 15D scores. Qual Life Res 2015; 24(3): 599−606.
Korhonen PE, Seppälä T, Kautiainen H, Järvenpää S, Aarnio PT, Kivelä SL. Ankle-brachial index and health-related quality of life. Eur J Prev Cardiol 2012; 19(5): 901−7.
Ludt S, Wensing M, Szecsenyi J, van Lieshout J, Rochon J, Freund T, et al. Predictors of health-related quality of life in patients at risk for cardiovascular disease in European primary care. PLoS ONE 2011; 6(12): e29334.
Sprengers RW, Teraa M, Moll FL, de Wit GA, van der Graaf Y, Verhaar MC. JUVENTAS Study Group. SMART Study Group. Quality of life in patients with no-option critical limb ischemia underlines the need for new effective treatment. J Vasc Surg 2010; 52(4): 843−9, 849.e1.
Martinez-Martin P, Jeukens-Visser M, Lyons KE, Rodriguez-Blazquez C, Selai C, Siderowf A, et al. Health-related quality-of-life scales in Parkinson's disease: critique and recommenda-tions. Mov Disord 2011; 26(13): 2371−80.
Mapes DL, Lopes AA, Satayathum S, McCullough KP, Goodkin DA, Locatelli F, et al. Health-related quality of life as a predic-tor of mortality and hospitalization: the Dialysis Outcomes and Practice Patterns Study (DOPPS). Kidney Int 2003; 64(1): 339−49.
White SL, Chadban SJ, Jan S, Chapman JR, Cass A. How can we achieve global equity in provision of renal replacement therapy? Bull World Health Organ 2008; 86(3): 229–37
Schieppati A, Remuzzi G. Chronic renal diseases as a public health problem: epidemiology, social, and economic implica-tions. Kidney Int Suppl 2005; (98): S7−S10.
Petrovic L, Mitic I, Bozic D, Vodopivec S, Djurdjevic-Mirkovic T. Quality of life in patients with chronic renal failure. Med Pregl 2006; 59(9−10): 411−4. (Serbian)
Dedić G, Milojković N, Čukić Z, Bokonjić D. Quality of life of hemodialysis patients waiting for kidney transplantation. Voj-nosanit Pregl 2017; 74(8): doi: 10.2298/VSP150918259D.
Nezu S, Okamoto N, Morikawa M, Saeki K, Obayashi K, Tomioka K, et al. Health-related quality of life (HRQOL) decreases in-dependently of chronic conditions and geriatric syndromes in older adults with diabetes: the Fujiwara-kyo Study. J Epidemiol 2014; 24(4): 259−66.
Murali R, Sathyanarayana D, Muthusethupathy MA. Assessment of quality of life in chronic kidney disease patients using the kidney disease quality of life-short formTM questionnaire in Indian population: A community based study. Asian J Pharm Clin Res 2015; 8(1): 271−4.
Maenpaa J, Puistola U, Riska H, Sintonen H, Saarni O, Juvonen E, et al. Impact of Epoetin-beta on Anemia and Health-related Quality of Life in Cancer Patients: A Prospective Observational Study Using the Generic 15D Instrument. Anticancer Res 2014; 34(5): 2325−9.
Mazur W, Kupiainen H, Pitkäniemi J, Kilpeläinen M, Sintonen H, Lindqvist A, et al. Comparison between the disease-specific Airways Questionnaire 20 and the generic 15D instruments in COPD. Health Qual Life Outcomes 2011; 9: 4.
Sintonen H. The 15D instrument of health-related quality of life: Properties and applications. Ann Med 2001; 33(5): 328−36.
Landreneau K, Lee K, Landreneau MD. Quality of life in patients undergoing hemodialysis and renal transplantation-a meta-analytic review. Nephrol Nurs J 2010; 37(1): 37−44.
Thaweethamecharoen T, Srimongokol W, Noparatayaporn P, Jariyay-othin P. Patient-Reported Outcomes (PRO) of Quality of Life (QOL) studies validity and reliability of KDQOK-36 in Thai Kidney Disease Patients. Value Health Reg Issues 2013; 2: 98−102.
Bugarski V, Sakac V, Vodopivec S, Slankamenac P. Relation be-tween personality dimensions and depressive symptoms in pa-tients on hemodialysis. Med Pregl 2010; 63(5−6): 305−12. (Serbian)
Park JI, Kim M, Kim H, An JN, Lee J, Yang SH, et al. Not early referral but planned dialysis improves quality of life and de-pression in newly diagnosed end stage renal disease patients: a prospective cohort study in Korea. PLoS One 2015; 10(2): e0117582.
Jaar BG, Chang A, Plantinga L. Can we improve quality of life of patients on dialysis? Clin J Am Soc Nephrol 2013; 8(1): 1−4.
Stojanovic M, Stojanovic D, Stefanovic V. The impact of malnutri-tion on mortality in patients on maintenance hemodialysis in Serbia. Artif Organs 2008; 32(5): 398−405.
Theofilou P. Quality of life in patients undergoing hemodialysis or peritoneal dialysis treatment. J Cliln Med Res 2011; 3(3): 132−8.
Germin-Petrovic D, Mesaros-Devcic I, Lesac A, Mandic M, Soldatic M, Vezmar D, et al. Health-related quality of life in the patients on maintenance hemodialysis: The analysis of demographic and clinical factors. Coll Antropol 2011; 35(3): 687−93.
Sayin A, Mutluay R, Sindel S. Quality of life in hemodialysis, peritoneal dialysis, and transplantation patients. Transplant Proc 2008; 39(10): 3047−53.
Tonelli M, Wiebe N, Knoll G, Bello A, Browne S, Jadhav D, et al. Systematic review: Kidney transplantation compared with di-alysis in clinically relevant outcomes. Am J Transplant 2011; 11(10): 2093−109.
Mazairac AH, Grooteman MP, Blankestijn PJ, Penne EL, van der Weerd NC, den Hoedt CH, et al. Differences in quality of life of hemodialysis patients between dialysis centers. Qual Life Res 2012; 21(2): 299−307.
Stojanovic M, Stefanovic V. Assessment of Health-related quality of life in patients treated with hemodialysis in Serbia: Influence of comorbidity, age, and income. Artif Organs 2007; 31(1): 53−60.
Vukadinovic N. The quality of life of chronically ill patients. Opšta medicina 2011; 17(1−2): 56−61. (Serbian)