nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical Universitynefr-181Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИ КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯORIGINAL ARTICLES CLINICAL STUDIESКачество жизни и отдаленная сердечно-сосудистая выживаемость больных на гемодиализеQuality of life and long-term cardiovascular survival of patients on hemodialysisДобронравовВладимир АлександровичDobronravovVladimir A.dobronravov@nephrolog.ruВасильеваИрина АндреевнаVasilievaIrina A.ira707@yandex.ruБабарыкинаЕлена ВикторовнаBabarykinaElena V.elena_babarykina@mail.ruНаучно-исследовательский институт нефрологии Научно-клинического исследовательского центра Первого Санкт-Петербургского государственного медицинского университета им. акад. И.П.Павлова; 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 University; Pavlov First Saint-Petersburg State Medical UniversityRussian FederationНаучно-исследовательский институт нефрологии Научно-клинического исследовательского центра Первого Санкт-Петербургского государственного медицинского университета им. акад. И.П.ПавловаРоссияResearch Institute of Nephrology, Scientific and Clinical Research Centre, Pavlov First Saint-Petersburg State Medical UniversityRussian FederationОбластная клиническая больницаРоссияOmsk Regional Clinical HospitalRussian Federation2016010520162037884Copyright © Добронравов В.А., Васильева И.А., Бабарыкина Е.В., 20162016Добронравов В.А., Васильева И.А., Бабарыкина Е.В.Dobronravov V.A., Vasilieva I.A., Babarykina E.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/181

ЦЕЛЬ ИССЛЕДОВАНИЯ. Проверка гипотезы о связи показателей качества жизни (КЖ) с риском смерти пациентов на гемодиализе (ГД) от сердечно-сосудистых (СС) причин. ПАЦИЕНТЫ И МЕТОДЫ. В длительное проспективное наблюдательное исследование было включено 255 превалентных пациентов на ГД. При включении в исследование у всех больных были определены параметры КЖ по методике SF-36 и клинические показатели с целью оценки их прогностической значимости в отношении риска смерти от СС-осложнений. В дальнейшем из анализа рисков кардиоваскулярной смерти были исключены 39 пациентов, причина смерти которых осталась неизвестной. РЕЗУЛЬТАТЫ. Среднее время наблюдения за больными составило 65,7±48,3 мес. В группе больных, умерших от СС-осложнений (n=71), шесть из восьми исходных показателей КЖ были достоверно ниже, чем среди выживших или умерших от других причин (n=145). По исходным показателям психического здоровья и ролевого эмоционального функционирования различий между группами умерших от СС-причин и не умерших от них не выявлено. Показатель физического функционирования (ФФ) был достоверно и независимо связан с риском СС-смерти в множественной регрессионной модели Кокса, скорректированной по клиническим факторам риска (ExpB (95% confidence interval) =0,987 (0,975-0,998), p=0,025). ЗАКЛЮЧЕНИЕ. Установлено, что показатель физического функционирования (ФФ) методики SF-36 является независимым предиктором риска фатальных СС-событий в популяции превалентных больных на ГД.

THE AIM. To test the hypothesis of the association of quality of life (QOL) scores with the risk of cardiovascular death in hemodialysis (HD) pts population. PATIENTS AND METHODS. Two hundred and fifty five prevalent HD pts were enrolled in the long-term prospective observational study. Patient’s baseline QOL scores assessed by SF-36 and clinical variables were measured to evaluate their relationships with cardiovascular death. Thirty nine pts whose causes of death remained unknown were excluded from the final analysis. The mean follow-up period was 65,7±48,3 months. RESULTS. Baseline scores of six QOL scales were significantly lower in the group of pts who died from cardiovascular complications during the follow-up period (n=71) compared with the combined group of those were alive or died from other causes. Differences in Mental Health and Role Emotional scores between groups were not significant. Physical Functioning score (PF) had a significant association with the risk of cardiovascular death in HD patients in multivariable Cox proportional-hazard model adjusted by other clinical confounders (ExpB (95% confidence interval) =0,987 (0,975-0,998), p=0,025). CONCLUSION. Physical Functioning score (PF) appeared to be the independent predictor of fatal cardiovascular events in the population of prevalent HD pts.

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