| Background and objective Refractory congestive heart failure(RCHF),a serious disease with high mortality,is the end stage of various cardiovascular diseases which is an important risk factor for people’s health and quality of life.There is currently no effective treatment except heart transplant.Due to poor heart function,patients with RCHF show decreased exercise capacity,poor life quality and sleep quality compared with normal people,which contribute to a significant increase in the hospitalization rate,significantly increase the cost and motality of patients.Patients with RCHF are always accompanied by renal dysfunction and not sensitive to conventional-dose diuretic therapy.In this context,extra-corporeal ultrafiltration is an effective treatment method of removing water from the body that can reduce the burden of heart and improve patients’ condition and mainly include hemodialysis(HD)and peritoneal dialysis(PD).Recent studies have shown that the clinical symptom of patients can be effectively alleviated and quality of life in RCHF patients could be improved by using extra-corporeal ultrafiltration.At present,studies on the effects of dialysis on sleep quality and life quality in non-uremic patients with RCHF are few.Therefore,data on non-uremic patients with RCHF using PD or HD in our hospital recent years were collected for analysis to investigate the effect of PD and HD on sleep and life quality in non-uremic patients with RCHF.Methods Thirty-one PD and seventeen HD non-uremic RCHF patients from January 1st 2010 to December 31 st 2017 were included in this retrospective study.Data before and 6 months after dialysis were collected,including blood examinations such as B-type natriuretic peptide(BNP),New York Heart Association functional classification(NYHA),left ventricular ejection fraction(LVEF),24-hour urine volume and the MOS item short from health survey(SF-36),Pittsburgh Sleep Quality Index(PSQI).All tests were performed using SPSS version 17.0.Results 1.After six months treatment,both PD and HD effectively improved NYHA classification and reduced BNP levels(p<0.01).There was no statistical difference between the two groups.(p>0.05).Neither PD nor HD significantly improved left ventricular ejection fraction after 6-month dialysis(p>0.05).2.Renal function and urine volume of patients decreased significantly after HD treatment(p<0.05).Statistically significant difference of renal function was not found after PD treatment(p>0.05),but the volume of urine increased significantly after PD treatment(p<0.01).Compared with HD,the renal function and the volume of urine in PD group was significantly improved.3.Sleep quality was improved for HD patients except hypnotic drugs and daytime function(p<0.05).And sleep quality was improved for PD patients except hypnotic drugs(p<0.05).Total PSQI scores were increased for both HD and PD modalities(p<0.05).There was no statistical difference between the two groups.(p>0.05).4.Life quality was significantly improved for HD patients except role-emotional(p<0.05),while all eight life quality items were improved for PD patients(p<0.01).After treatment,PD patients had higher scores than HD patients in life quality items except physical function(all p<0.05).Logistic regression analysis showed that PD was associated with better role-emotional and role-physical than HD(p<0.05).Conclusions 1.Both PD and HD can significantly improve the clinical heart status of patients with RCHF,and the efficacy is equivalent,but neither PD nor HD can significantly improve the LVEF level of patients.2.PD can significantly improve the renal function of patients compared with HD.3.Sleep quality was equally improved by PD and HD treatment,while PD has better quality of life than HD. |
PDF Full Text Request