Cross-sectional Comparison Of Quality Of Life Between Hemodialysis And Non-dialysis Treatment For Elderly Patients With End-stage Renal Disease

Objective: 36-Item Short-Form Healthy Survey Questionnaire was used to compare the effects of hemodialysis or non-dialysis on the quality of life of older patients with end-stage renal disease,and to analyze the related factors affecting the quality of life of patients.The quality of life status of patients with two different treatment methods was further analyzed from the aspects of nutritional status,depression status,cognitive status,daily activity ability,etc.,so as to provide scientific basis for exploring scientific and reasonable treatment plans to improve and enhance the quality of life of patients with end-stage renal disease over 65 years old.Method: In this study,patients with end-stage renal disease who underwent non-dialysis treatment and hemodialysis treatment at the Naval General Hospital from December 2017 to June 2018 were selected as subjects,while those health person of the same age were selected as the control group,totaling 154 cases,including 48 cases in non-dialysis group,54 cases in hemodialysis group and 52 cases in healthy control group.A face-to-face questionnaire was conducted for all enrolled patients.The survey included general demographic characteristics such as patient age,gender,clinical data such as primary cause,education level,annual income,marital status,and health status(Medical).Outcomes Study Health Status Short Form(SF-36),Malnutrition Inflammation Score(MIS),Activies of Daily Living(ADL),and Geriatric Depression Scale-15(GDS-15),Montreal Cognitive Assessment(MOCA).Collect clinical laboratory data during the investigation,such as blood calcium,phosphorus,hemoglobin,serum albumin,prealbumin,triglycerides,cholesterol,high-sensitivity C-reactive protein,etc.To compare the general demographic characteristics,laboratory indicators,depression status,and cognitive status among the three groups of patients,and to understand the status of quality of life in elderly hemodialysis and non-dialysis patients;The subject’s quality of life score was taken as the dependent variable,and the general demographic characteristics,laboratory indicators,depression status,and cognitive status were used as independent variables.Multiple linear regression analysis was established to analyze the relevant risk factors affecting the quality of life of patients undergoing hemodialysis and non-dialysis treatment.Result : 1.There was no significant difference in age,sex,marital status,education level,triglyceride,low density lipoprotein cholesterol,prealbumin,diastolic blood pressure and Bady Mass Index(BMI)among hemodialysis patients、non-dialysis patients and healthy control group patients.(P > 0.05).2.Compared with patients in the healthy control group,patients in the hemodialysis group and the non-dialysis group have significantly lower hemoglobin,cholesterol,high density lipoprotein cholesterol,serum albumin,blood calcium,estimated glomerular filtration rate,charlson complication index,and significantly higher levels of blood phosphorus,intact parathyroid hormone,high sensitivity C-reactive protein,systolic blood pressure,significantly higher incidence of malnutrition,cognitive impairment,depression,and significantly lower ability of daily activities(P<0.05).3.Compared with patients in hemodialysis group,the levels of hemoglobin,serum albumin,blood calcium,intact parathyroid hormone and high-sensitivity C-reactive protein in patients in non-dialysis group are significantly reduced,and the malnutrition and depression symptoms is significantly increased(P<0.05),while the difference in the incidence of daily activities and cognitive impairment is not statistically significant(P > 0.05).4.Compared with the patients in the health control group,the scores of patients in the hemodialysis group and the non-dialysis group in all dimensions of SF-36 were significantly reduced(P<0.05).5.Compared with patients in hemodialysis group,patients in non-dialysis group have significantly lower scores in physiological function,bodily pain,general healthy,vitality,physiological comprehensive score(P<0.05),while there is no significant difference in physiological function,social function,role emotional,mental health,mental comprehensive score(P > 0.05).6.Univariate correlation analysis and multi-factor stepwise regression analysis found that the comprehensive score of quality of life of hemodialysis patients was significantly positively correlated with education level(P < 0.05),and was significantly negatively correlated with GDS score,age and marital status(P < 0.05).7.Univariate correlation analysis and multi-factor stepwise regression analysis found that the comprehensive quality of life score of non-dialysis patients was significantly positively correlated with education level,annual income and MOCA score(P< 0.05),and was significantly negatively correlated with marital status(P < 0.05).Conclusion: 1.The quality of life of patients with end-stage renal disease treated non-dialysis and hemodialysis patients is poor,and the overall quality of life of hemodialysis patients is higher than that of patients treated non-dialysis.2.Depression,age,educational level and marital status are the factors that affect the quality of life of hemodialysis patients.3.Education level,marital status,cognitive and annual income are the factors that affect the quality of life of non-dialysis patients.