Kvalitet života bolesnika na hemodijalizi predviđenih za transplantaciju

  • Gordana Dedić Military Medical Academy, Clinic for Psychiatry, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Nenad Milojković Military Medical Center New Belgrade, Belgrade, Serbia
  • Zoran Čukić Military Medical Academy, Clinic for Nephrology, Belgrade, Serbia
  • Dubravko Bokonjić Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, National Poison Control Center, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP150918259D
Ključne reči: renal dialysis||, ||bubreg, dijaliza, kidney transplantation||, ||transplantacija bubrega, quality of life||, ||kvalitet života, surveys and questionnaires||, ||ankete i upitnici,

Sažetak


Uvod/Cilj. Dijaliza i transplantacija bubrega primenjuju se u lečenju bolesnike u terminalnoj fazi bubrežne insuficijencije. Postoji malo informacija o kvalitetu života bolesnika na dijalizi predviđenih za transplantaciju, grupi bolesnika koja se povećava u celom svetu. Cilj istraživanja bio je procena kvaliteta života bolesnika na dijalizi u terminalnoj fazi bubrežne insuficijencije, predviđenih za transplantaciju bubrega. Metode. U kliničkoj komparativnoj jednogodišnjoj studiji, poređene su vrednosti kvaliteta života bolesnika na dijalizi predviđenih za transplantaciju (N = 24) i bolesnika koji nisu predviđeni za transplantaciju (N = 52) bubrega. U istraživanje su bili uključeni samo bolesnici stariji od 18 godina,  koji su bili na dijalizi najmanje tri meseca. Za merenje kvaliteta života je korištena kratka forma Upitnika kvaliteta života (SF-36). Rezultati. Bolesnici predviđeni za transplantaciju bubrega bili su mlađi (43,50 ± 12,64 vs 63,58 ± 13,88 godina; p < 0,001), dijalizu su započeli u mlađem životnom dobu (32,38 ± 14,50 vs 57,12 ± 15,79 godine; (p < 0,001) i na dijalizi su duže od bolesnika koji nisu bili predviđeni za transplantaciju (112,04 ± 82,48 vs 72,40 ± 81,31 meseci; p < 0,05). Komorbiditet je bio veći kod bolesnika koji nisu bili predviđeni za transplantaciju p < 0,01). U laboratorijskim parametrima postojala je statistički značajna razlika za vrednosti kreatinina (p < 0,01) i fosfora (p < 0,05) u serumu i broja koji kvantifikuje adekvatnost hemodijalize (Kt/V index: K – dijalizni klirens uree; t – vreme dijalize; V – volumen distribucije ureee približno jednak ukupnoj telesnoj vodi bolesnika) (1,36 ± 0,12 vs 1,29 ± 0,19; p < 0,05). Na Upitniku kvaliteta života, bolesnici koji su bili predviđeni za transplantaciju u odnosu na one koji nisu bili predviđeni za transplantaciju imali su više srednje vrednosti za: Fizičko funkcionisanje (PF) (83,33 ± 10,59 vs 66,53 ± 27,87; p > 0,05), Ograničenje zbog fizičkih teškoća (RP) (58,66 ± 21,39 vs 46,90 ± 23,73; p > 0,05), Percepciju opšteg zdravlja (GH) (45,00 ± 14,81 vs 37,98 ± 12,88; p > 0,05); Socijalno funkcionisanje (SF) (93,66 ± 16,10 vs 78,30 ± 29,80; p > 0,05), kao i za domen Fizičko zdravlje (PCS) (64,16 ± 13,77 vs 52,38 ± 19,53; p > 0,05). Zaključak. Bolesnici predviđeni za transplantaciju bili su mlađeg životnog doba, dijalizu su počeli u mlađim godinama života, na dijalizi su bili duže od bolesnika koji nisu bili predviđeni za transplantaciju. Niži komorbiditet, bolje laboratorijske vrednosti bili su u saglasnosti sa višim skorom na svim domenima kvaliteta života bolesnika predviđenih za transplantaciju, posebno u vezi sa njihovim boljim opštim zdravstvenim stanjem, fizičkom sposobnosti i socijalnim funkcionisanjem.

 

Biografija autora

Gordana Dedić, Military Medical Academy, Clinic for Psychiatry, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia

Redovni profesor psihijatrije,

Načelnik odeljenja

Klinika za psihijatriju VMA

 

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Objavljeno
2017/09/19
Broj časopisa
Vol. 74 Br. 8 (2017)
Rubrika
Originalni članak