| Objective Comparative Analysis of the effects of Peritoneal Dialysis and Hemodialysis on the quality of Life in patients with end-stage Diabetic Nephropathy.Methods Patients with diabetic nephropathy who received continuously dialysis treatment for the first time and survived for more than one year in the dialysis center of our hospital from January 1,2014 to January 1,2019 were collected.Hamilton scale was used to evaluate the mental and psychological status of patients,ECOG activity index scale and Karnofsky activity index scale were used to evaluate patients’ activity ability,SF-36 scale was used to evaluate patients’ quality of life.Multiple linear regression analysis was used to analyze the independent influencing factors of patients’ quality of life.The changes of laboratory indexes,psychological status,activity index,quality of life and the incidence of adverse events during dialysis were compared between the two groups after one year of treatment.Results A total of 130 patients were included,including 98 males(75.4%),with an average age of(55.07±10.70)years,peritoneal dialysis group(n=65)and hemodialysis group(n=65).(1)Comparison of baseline: there was no significant difference in sex,age,body mass index,blood pressure,residual renal function before dialysis,smoking history and drinking history between the two groups(P>0.05).(2)One year after dialysis,compared with HD patients,the levels of systolic blood pressure,diastolic blood pressure,mean arterial pressure,albumin and parathyroid hormone were lower(P<0.05),while fasting blood glucose,triglyceride and low density lipoprotein in PD patients were higher than those in HD patients(P<0.05).There was no significant difference in hemoglobin,serum iron,serum calcium,serum phosphorus,total cholesterol and high densitylipoprotein between the two groups(P>0.05).(3)One year after dialysis,compared with HD patients,the comprehensive score of SF-36 scale was higher in PD patients [(64.97±16.96)VS(54.71±18.20)](P<0.05);the proportion of anxiety and depression was low [(27.7% and 36.9%)VS(47.7% and 56.9%)](P<0.05);the evaluation of ECOG and Karnofsky activity ability was significantly better than that of HD patients(P <0.05).(4)Comparison of the incidence of adverse events between the two groups: the infection risk of peritoneal dialysis patients was significantly higher than that of hemodialysis patients(P<0.05),while the incidence of cardiovascular events and bleeding was significantly lower than that of hemodialysis patients(P<0.05).There was no significant difference in cerebrovascular diseases between the two groups(P>0.05).(5)Multiple linear regression analysis showed that anxiety and depression were independent factors affecting the quality of life in peritoneal dialysis patients,while triglyceride and depression were independent influencing factors of quality of life in hemodialysis patients.Conclusion 1.One year after dialysis treatment,the quality of life in diabetic nephropathy patients with peritoneal dialysis is better than that of hemodialysis.2.The diabetic nephropathy patients who received peritoneal dialysis had better control of blood pressure,lower incidence of anxiety and depression and higher activity index,but the level of plasma albumin was lower than that of hemodialysis,and the disorder of glucose and lipid metabolism was more likely to occur,and the incidence of infection is relatively high.3.The level of plasma albumin in patients with diabetic nephropathy treated by hemodialysis is relatively high,and the risk of infection is relatively low,but the incidence of cardiovascular events,bleeding and other complications is higher.4.Depression is an independent factor affecting the quality of life in dialysed patients with diabetic nephropathy. |
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