Quality-of-Life and Mortality in Hemodialysis Patients
| Autor: | Keith C. Norris, Usama Feroze, Kamyar Kalantar-Zadeh, Csaba P. Kovesdy, Debbie Benner, David J. Martin, Nazanin Noori, Joel D. Kopple, Rachelle Bross, Miklos Z. Molnar, Astrid Reina-Patton |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Epidemiology Health Status Psychological intervention Nutritional Status Critical Care and Intensive Care Medicine Cohort Studies Quality of life Renal Dialysis Internal medicine medicine Humans Prospective Studies Wasting Serum Albumin Aged Transplantation business.industry Proportional hazards model Hazard ratio Original Articles Middle Aged Mental health United States Black or African American Adipose Tissue Nephrology Creatinine Cohort Quality of Life Physical therapy Kidney Failure Chronic Female Risk Adjustment medicine.symptom business Cohort study |
| Zdroj: | Clinical Journal of the American Society of Nephrology. 6:1100-1111 |
| ISSN: | 1555-9041 |
| Popis: | Summary Background and objectives Maintenance hemodialysis (MHD) patients often have protein-energy wasting, poor health-related quality of life (QoL), and high premature death rates, whereas African-American MHD patients have greater survival than non-African-American patients. We hypothesized that poor QoL scores and their nutritional correlates have a bearing on racial survival disparities of MHD patients. Design, setting, participants, & measurements We examined associations between baseline self-administered SF36 questionnaire–derived QoL scores with nutritional markers by multivariate linear regression and with survival by Cox models and cubic splines in the 6-year cohort of 705 MHD patients, including 223 African Americans. Results Worse SF36 mental and physical health scores were associated with lower serum albumin and creatinine levels but higher total body fat percentage. Spline analyses confirmed mortality predictability of worse QoL, with an almost strictly linear association for mental health score in African Americans, although the race–QoL interaction was not statistically significant. In fully adjusted analyses, the mental health score showed a more robust and linear association with mortality than the physical health score in all MHD patients and both races: death hazard ratios for (95% confidence interval) each 10 unit lower mental health score were 1.12 (1.05–1.19) and 1.10 (1.03–1.18) for all and African American patients, respectively. Conclusions MHD patients with higher percentage body fat or lower serum albumin or creatinine concentration perceive a poorer QoL. Poor mental health in all and poor physical health in non-African American patients correlate with mortality. Improving QoL by interventions that can improve the nutritional status without increasing body fat warrants clinical trials. |
| Databáze: | OpenAIRE |
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