Kvalitet života bolesnika na hroničnoj hemodijalizi i sa transplantiranim bubregom

Abstract

U toku protekle dve decenije razvijeno je nekoliko metoda merenja kvaliteta života, koji su primenjeni kod različitih kategorija zdravih i bolesnih ljudi, uključujući i obolele od hronične bubrežne bolesti (HBB). SZO organizacija svrstava HBB na dvanaesto mesto među vodećim uzrocima smrti u svetu. U terminalnoj fazi HBB neophodno je nadomestiti nedostatak bubrežne funkcije aktivnom terapijom- transplantacijom, peritoneumskom dijalizom ili hemodijalizom. Cilj aktivne terapije jeste nadoknada nedostajuće funkcije bubrega, ali takođe i poboljšanje kvaliteta života Cilj ovog istraživanja bio je da se ispita kvalitet života u populaciji obolelih od hronične bubrežne bolesti koji su na hroničnoj hemodijalizi, i sa transplantiranim bubregom, da se ispita povezanost kvaliteta života sa demografskim, socio-ekonomskim, kliničkim karakteristikama i komorbiditetom u obe ispitivane grupe pacijenata, uporede parametri kvaliteta života u ispitivanim grupama i na osnovu toga donese zaključak o uticaju različitih vidova lečenja na kvalitet života kod obolelih od hronične bubrežne bolesti. Analiza srednjih vrednosti ukupnog 15D skora pokazala je da je kvalitet života statistički značajno bolji kod ispitanika sa transplantiranim bubregom u poređenju sa ispitanicima na hemodijalizi (0,92±0,09 prema 0,78±0,15). Utvrđena je negativna povezanost kvaliteta života sa godinama života radnim statusoom i ICED skorom, a pozitivna sa koncentracijom hemoglobina i kreatinina u hemodijaliziranoj grupi. U grupi transplantiranih pacijenata kvalitet života je negativno korelirao sa godinama života, radnim statusom i ICED skorom. Multivarijantna regresiona analiza pokazala je da su nezavisni prediktorin kvaliteta života pacijenata na hemodijalizi bili: godine života i ICED skor, dok u grupi sa transplantiranim bubregom to su bili: ICED skor, godine života i zaposlenje.

During the past two decades sciences developed several methods for measuring quality of life, which are applied in different categories of healthy and sick people, including for patients suffering from chronic kidney disease (CKD). WHO classifies CKD on the twelfth place of the leading causes of death in the world. In the terminal stage CKD is necessary to compensate the lack of renal function with an active therapy - renal transplantation, peritoneal dialysis or hemodialysis. The aim of active treatment is compensation missing kidney function, but also improvment of the quality of life. The aim of this study was to investigate the quality of life in a population of patients with chronic kidney disease who are on hemodialysis, and renal transplantation, to investigate the connection between quality of life with demographic, socio-economic, clinical characteristics and comorbidity in both groups of patients, comparing the parameters of quality of life in the examined groups on the basis of a conclusion about the impact of different forms of treatment on quality of life in patients with CKD. Analysis of the mean values of the total 15D score showed that the quality of life was significantly better in patients with kidney transplantation compared to those on hemodialysis (0.92 ± 0.09 vs. 0.78 ± 0.15). There was a negative correlation between the quality of life with patients age, employment status and ICED, while positive correlation was detected with the hemoglobin concentration and creatinine in hemodialysis group. In the group of patients with kidney transplantation, quality of life was negatively correlated with the patients age, employment status and ICED. Multivariate regression analysis showed that independent predictors of quality of life in hemodialysis patients group were: patients age and ICED score, while in the group of patients with the transplanted kidney it was: ICED score, patients age and employment.