nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2019-23-4-80-87nefr-1725Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИ. КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯORIGINAL ARTICLES. CLINICAL INVESTIGATIONSКачество жизни больных с сахарным диабетом, находящихся на лечении гемодиализомThe quality of life in diabetic hemodialysis patientshttps://orcid.org/0000-0002-9039-6613ВасильеваИ. А.VasilievaI. A.

Васильева Ирина Андреевна - докторр психологических наук, лаборатория почечной недостаточности, старший научный сотрудник.

197022, Санкт-Петербург, ул. Л. Толстого, д. 17, корп. 54, Тел.: (812) 338-69-34

Irina A. Vasilieva PhD, DPsycholSci, Laboratory of Renal Insufficiency, senior researcher.

197022, St-Petersburg, L. Tolstoy st., 17, build. 54, Phone (812) 338-69-34

ira707@yandex.ruГолубевР. В.GolubevR. V.

Голубев Роман Владимирович - кандидат медицинских наук, лаборатория почечной недостаточности, зав. лабораторией.

Roman V. Golubev - MD, PhD, Laboratory of Renal Insufficiency, head of laboratory.

197022, St-Petersburg, L. Tolstoy st., 17, build. 54, Phone (812) 338-69-34

romvladgol@gmail.comВасильевА. Н.VasilyevA. N.

Васильев Александр Николаевич - кандидат медицинских наук, отделение хронического гемодиализа, зав. отделением.

197022, Санкт-Петербург, ул. Л. Толстого, д. 17, корп. 54, Тел.: (812) 338-69-14

Alexander N. Vasilyev - MD, PhD, Department of Chronic Hemodialysis, head of department.

197022, St-Petersburg, L. Tolstoy st., 17, build. 54, Phone (812) 338-69-14

vasilyev53@gmail.comhttps://orcid.org/0000-0001-7863-9080СмирновА. В.SmirnovA. V.

Смирнов Алексей Владимирович - докор медицинских наук, профессор, директор НИИН НИЦ; заведующий кафедрой пропедевтики внутренних болезней.

197022, Санкт-Петербург, ул. Л. Толстого, д. 17, корп. 54, Тел.: (812) 338-69-01

Alexey V. Smirnov - MD, PhD, DMedSci, Prof., director RINSCRC ; head of the department of propedeutics of internal diseases.

197022, St-Petersburg, L. Tolstoy st., 17, build. 54, Phone (812) 338-69-01

smirnov@nephrolog.ruНаучно-исследовательский институт нефрологии Научно-клинического исследовательского центра, Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. ПавловаРоссияResearch Institute of Nephrology, Scientific and Clinical Research Centre, Pavlov First Saint-Petersburg State Medical UniversityRussian Federation2019230620192348087Copyright © Васильева И.А., Голубев Р.В., Васильев А.Н., Смирнов А.В., 20192019Васильева И.А., Голубев Р.В., Васильев А.Н., Смирнов А.В.Vasilieva I.A., Golubev R.V., Vasilyev A.N., Smirnov A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/1725Цель

Цель. Сравнить качество жизни (КЖ) больных с сахарным диабетом (СД) и без него, получающих лечение гемодиализом (ГД), и оценить влияние фактора диабета на показатели КЖ.

Пациенты и методы

Пациенты и методы. При помощи опросника the Kidney Disease Quality of Life Short Form (KDQOL-SF™) обследовали 192 превалентных больных, находившихся на лечении ГД. Из них 23 пациента страдали СД.

Результаты

Результаты. По сравнению с ГД пациентами без СД, у больных с СД были существенно ниже показатели физической составляющей КЖ: Физическое функционирование - 30.0 (10.0-45.0) против 65.0 (40.0-80.0) (Me[IQR]), p<0.0001; Боль - 45.0 (32.5-67.5) против 57.5 (45.0-90.0), p=0.046; Суммарный показатель физического здоровья (PCS) - 25.4 (20.5-35.3) против 36.6 (29.8-44.5), p<0.0001. При наличии СД шансы (95% ДИ) того, что показатель шкалы Ролевого физического функционирования будет ниже 50 баллов, были в 6.7 (1.5-29.6) выше, чем при отсутствии СД. У ГД пациентов с СД был также ниже, чем у больных без него, балл по шкале Энергичности: 40.0 (25.0-45.0) vs 45.0 (35.0-60.0), p=0.006. Из числа диализ-специфических шкал опросника у пациентов с СД были ниже показатели Симптомы/проблемы - 64.6 (58.3-70.8) vs 75.0 (62.5-85.4), p=0.012 и Сон - 47.5 (35.0-62.5) vs 57.5 (45.0-72.5), p=0.012. При наличии СД шансы того, что показатель шкалы Трудового статуса будет ниже 50 баллов, были в 7.8 (1.8-34.3) выше, чем при отсутствии СД.

Заключение

Заключение. Оценки шкал самооценки физического здоровья, Энергичности, Симптомов/проблем, Сна и Трудового статуса были существенно ниже у пациентов ГД, страдающих СД, чем у больных без СД.

The aim

The aim: to compare the quality of life (QOL) in hemodialysis (HD) patients with diabetes and without it and to evaluate the impact of diabetes on QOL variables.

Patients and methods

Patients and methods. 192 prevalent HD patients completed the Kidney Disease Quality of Life Short Form (KDQOL-SF™) questionnaire. Of these, 23 patients had diabetes.

Results

Results. Compared with non-diabetic HD patients, HD patients with diabetes scored lower on physical component of QOL: the Physical functioning scale - 30.0 (10.0-45.0) vs 65.0 (40.0-80.0) (Me[IQR]), p<0.0001; Bodily pain - 45.0 (32.5-67.5) vs 57.5 (45.0-90.0), p=0.046; Physical Component Summary (PCS) - 25.4 (20.5-35.3) vs 36.6 (29.8-44.5), p<0.0001. In the presence of diabetes, the Odds Ratio (95% CI) of the Role Physical scale score being below 50 were 6.7 (1.5-29.6) times higher than in the absence of diabetes. The Vitality scale score was also lower in diabetic HD patients: 40.0 (25.0-45.0) vs 45.0 (35.0-60.0), p=0.006. Regarding the dialysis-specific scales, diabetic patients had poorer scores than non-diabetics on Symptoms/problems - 64.6 (58.3-70.8) vs 75.0 (62.5-85.4), p=0.012 and Sleep - 47.5 (35.0-62.5) vs 57.5 (45.0-72.5), p=0.012. In the presence of diabetes, the Odds Ratio (95% CI) of the Work status scale score being below 50 were 7.8 (1.8-34.3) times higher than in the absence of diabetes.

Conclusion

Conclusion. Diabetic HD patients scored significantly lower than non-diabetic on the scales of self-reported physical health, Vitality, Symptoms/problems, Sleep and Work status.

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The authors declare that there are no conflicts of interest present.