nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2003-7-2-41-45nefr-905Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИ. КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯORIGINAL ARTICLES. CLINICAL INVESTIGATIONSКАЧЕСТВО ЖИЗНИ И ВЫЖИВАЕМОСТЬ БОЛЬНЫХ МОЛОДОГО ВОЗРАСТА, НАХОДЯЩИХСЯ НА ЛЕЧЕНИИ ХРОНИЧЕСКИМ ГЕМОДИАЛИЗОМQUALITY OF LIFE AND SURVIVAL OF YOUNG PATIENTS UNDERGOING CHRONIC HEMODIALYSIS TREATMENTБабарыкинаЕ. В.BabarykinaE. V.ВасильеваИ. А.VasilievaI. A.СмирноваЛ. М.SmirnovaL. M.ДобронравовВ. А.DobronravovV. A.Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова, Областная клиническая больницаRussian Federation200310022003724145Copyright © Бабарыкина Е.В., Васильева И.А., Смирнова Л.М., Добронравов В.А., 20032003Бабарыкина Е.В., Васильева И.А., Смирнова Л.М., Добронравов В.А.Babarykina E.V., Vasilieva I.A., Smirnova L.M., Dobronravov V.A.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/905

ЦЕЛЬ РАБОТЫ. Определить влияние показателей качества жизни с учетом других клинических данных на выживаемость у лиц молодого возраста, получающих лечение хроническим гемодиализом (ГД). ПАЦИЕНТЫ И МЕТОДЫ. Проведено проспективное наблюдение в течение 30 месяцев за 83 больными, получавшими лечение хроническим гемодиализом (ГД), в возрасте от 16 до 44 лет. Перед началом наблюдения у всех больных были определены показатели качества жизни по методике SF-36 и клинические показатели с целью оценки их прогностической значимости в отношении выживаемости больных. РЕЗУЛЬТАТЫ. В группе умерших больных (п=14) были достоверно ниже исходные показатели качества жизни: способности выдерживать физические нагрузки (PF), чувствительности к боли (BP) и суммарного показателя физического здоровья. ЗАКЛЮЧЕНИЕ. Установлено, что интегральный показатель физического здоровья, базирующийся на самооценке больного, является одним из важных независимых предикторов выживаемости лиц молодого возраста на гемодиализе наряду со средним объемом ультрафильтрации, кальций-фосфатным произведением, диаметром левого предсердия и типом ГД. Показатели психического здоровья обследованной группы больных с выживаемостью связаны не были.

THE AIM of the work was to determine the influence of life quality indices and other clinical data on survival of young patients on chronic hemodialysis (HD). PATIENTS AND METHODS. A prospective observation of 83 patients from 16 to 44 years of age treated by chronic HD was carried out during 30 months. Before the observation in all the patients the indices of life quality (by the SF-36 method) and clinical indices were determined for the assessment of their prognostic significance in relation to survival of the patients. RESULTS. In the group of the dead (n=14) the initial indices of life quality such as the ability to endure physical loads (PF), sensitiveness of pain, and a total index of physical health were lower. CONCLUSION. It was found that the integral index of physical health based on the self-appraisal of the patient is one of important independent predictors of survival of young patients on HD on a level with the average volume of ultrafiltration, calcium-phosphate product, diameter of the left atrium and HD type. The indices of mental health of the patient under study were not associated with survival.

качество жизнивыживаемостьгемодиализquality of lifesurvivalhemodialysisReferencesMingardi G. Quality of life and end stage renal disease therapeutic programs. DIA-QOL Group. Dialysis quality of life. Int J Artif Organs 1998; 21 (11): 741-747.Mingardi G. Quality of life and end stage renal disease therapeutic programs. DIA-QOL Group. Dialysis quality of life. Int J Artif Organs 1998; 21 (11): 741-747.Valderrabano F. Quality of life benefits of early anaemia treatment. Nephrol Dial Transplant 2000; 15, [Suppl.3]: 23-28.Valderrabano F. Quality of life benefits of early anaemia treatment. Nephrol Dial Transplant 2000; 15, [Suppl.3]: 23-28.Schatell D, Thompson N, Oberley E. Life Options Patient Opinion Study identifies keys to a long life for dialysis patients. Nephrol News & Issues 1999; 13, (4): 24-26.Schatell D, Thompson N, Oberley E. Life Options Patient Opinion Study identifies keys to a long life for dialysis patients. Nephrol News & Issues 1999; 13, (4): 24-26.Blake C, Codd MB, Cassidy A et al. Physical function, employment and quality of life in end-stage renal disease J Nephrol 2000; 13,(2): 142-149.Blake C, Codd MB, Cassidy A et al. Physical function, employment and quality of life in end-stage renal disease J Nephrol 2000; 13,(2): 142-149.Oberley ET, Sadler JH, Alt PS. Renal rehabilitation: obstacles, progress, and prospects for the future. Am J Kidney Dis 2000; 35, (4) [Suppl.1]: S141-S147.Oberley ET, Sadler JH, Alt PS. Renal rehabilitation: obstacles, progress, and prospects for the future. Am J Kidney Dis 2000; 35, (4) [Suppl.1]: S141-S147.Sadler JH. Health promotion for end-stage renal disease patients. Advanc Renal Replacement Ther 1998; 5 (4): 275-285.Sadler JH. Health promotion for end-stage renal disease patients. Advanc Renal Replacement Ther 1998; 5 (4): 275-285.Waiser J, Budde K1 Schreiber M. et al. The quality of life in end stage renal disease care. Transplant Int 1998; 11 [Suppl. 1]: S42-S45.Waiser J, Budde K1 Schreiber M. et al. The quality of life in end stage renal disease care. Transplant Int 1998; 11 [Suppl. 1]: S42-S45.Gokal R, Figueras M1 Olle A. et al. Outcomes in peritoneal dialysis and haemodialysis -a comparative assessment of survival and quality of life. Nephrol Dial Transplant 1999; 14 [Suppl. 6]: 24-30.Gokal R, Figueras M1 Olle A. et al. Outcomes in peritoneal dialysis and haemodialysis -a comparative assessment of survival and quality of life. Nephrol Dial Transplant 1999; 14 [Suppl. 6]: 24-30.DeOreo PB. Hemodialysis patient-assessed functional health status predicts continued survival, hospitalization, and dialysis-attendance compliance. Am J Kidney Dis 1997; 30 (2): 204-212.DeOreo PB. Hemodialysis patient-assessed functional health status predicts continued survival, hospitalization, and dialysis-attendance compliance. Am J Kidney Dis 1997; 30 (2): 204-212.Lopes AA, Bragg J, Young E, et al. Depression as a predictor of mortality and hospitalization among hemodialysis patients in the United States and Europe. Kidney Int 2002; 62: 199-207Lopes AA, Bragg J, Young E, et al. Depression as a predictor of mortality and hospitalization among hemodialysis patients in the United States and Europe. Kidney Int 2002; 62: 199-207McClellan WM1 Anson C, Birkeli K, et al. Functional status and quality of life: Predictors of early mortality among patients entering treatment for end stage renal disease. J Clin Epidemiol 1991;44:83-89.McClellan WM1 Anson C, Birkeli K, et al. Functional status and quality of life: Predictors of early mortality among patients entering treatment for end stage renal disease. J Clin Epidemiol 1991;44:83-89.Kimmel PL, Peterson RA, Weihs KL et al. Psychosocial factors, behavioral compliance and survival in urban hemodialysis patients. Kidneylnt 1998; 54 (1): 245-254.Kimmel PL, Peterson RA, Weihs KL et al. Psychosocial factors, behavioral compliance and survival in urban hemodialysis patients. Kidneylnt 1998; 54 (1): 245-254.Ifudu 0, Paul HR, Homel P et al. Predictive value of functional status for mortality in patients on maintenance hemodialysis. Am J Nephrol 1998;18:109-116.Ifudu 0, Paul HR, Homel P et al. Predictive value of functional status for mortality in patients on maintenance hemodialysis. Am J Nephrol 1998;18:109-116.Knight EL, Ofsthun N, Teng M et. al. The association between mental health, physical function, and hemodialysis mortality. Kidney Int 2003; 63 (5): 1843 -1852.Knight EL, Ofsthun N, Teng M et. al. The association between mental health, physical function, and hemodialysis mortality. Kidney Int 2003; 63 (5): 1843 -1852.Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey Manual and Interpretation Guide. Boston, 1993: 1-22.Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey Manual and Interpretation Guide. Boston, 1993: 1-22.Curtin RB, Lowrie EG, DeOreo PB. Self-reported functional status: an important predictor of health outcomes among end-stage renal disease patients. [Review], Advanc Renal Replacement Ther 1999; 6 (2): 133-140,Curtin RB, Lowrie EG, DeOreo PB. Self-reported functional status: an important predictor of health outcomes among end-stage renal disease patients. [Review], Advanc Renal Replacement Ther 1999; 6 (2): 133-140,Inouye SK, Peduzzi PN1 Robison JT et al. Importance of functional measures in predicting mortality among older hospitalized patients. JAMA 1998; 279: 1187-1193.Inouye SK, Peduzzi PN1 Robison JT et al. Importance of functional measures in predicting mortality among older hospitalized patients. JAMA 1998; 279: 1187-1193.Walter LC, Brand RJ, Counsell SR et al. Development and validation of a prognostic index for 1-year mortality in older adults after hospitalization. JAMA 2001; 285: 2987-2994.Walter LC, Brand RJ, Counsell SR et al. Development and validation of a prognostic index for 1-year mortality in older adults after hospitalization. JAMA 2001; 285: 2987-2994.Muder RR, Brennen C1 Swenson DL et al. Pneumonia in a long-term care facility. A prospective study of outcome. Arch Intern Med 1996; 156: 2365-2370.Muder RR, Brennen C1 Swenson DL et al. Pneumonia in a long-term care facility. A prospective study of outcome. Arch Intern Med 1996; 156: 2365-2370.Brezinski D, Stone PH, Muller JE et al. Prognostic significance of the Karnofsky Performance Status score in patients with acute myocardial infarction: Comparison with the left ventricular ejection fraction and the exercise treadmill test performance. The MILIS Study Group. Am Heart J 1991; 121: 1374-1381.Brezinski D, Stone PH, Muller JE et al. Prognostic significance of the Karnofsky Performance Status score in patients with acute myocardial infarction: Comparison with the left ventricular ejection fraction and the exercise treadmill test performance. The MILIS Study Group. Am Heart J 1991; 121: 1374-1381.Parkerson GR. Gutman RA. Health-related quality of life predictors of survival and hospital utilization. Health Care Financing flewew2000; 21 (3): 171-184.Parkerson GR. Gutman RA. Health-related quality of life predictors of survival and hospital utilization. Health Care Financing flewew2000; 21 (3): 171-184.Painter P, Carlson L, Carey S et al. Low-functioning hemodialysis patients improve with exercise training. Am J Kidney Dis 2000; 36: 600-608.Painter P, Carlson L, Carey S et al. Low-functioning hemodialysis patients improve with exercise training. Am J Kidney Dis 2000; 36: 600-608.Valderrabano F, Jofre R, Lopez-Gomez JM. Quality of life in end-stage renal disease patients. Am J Kidney Dis 2001; 38 (3): 443-464.Valderrabano F, Jofre R, Lopez-Gomez JM. Quality of life in end-stage renal disease patients. Am J Kidney Dis 2001; 38 (3): 443-464.Lopes AA, Bragg J, Young E et al. Depression as a predictor of mortality and hospitalization among hemodialysis patients in the United States and Europe. Kidney Int 2002; 62: 199-207.Lopes AA, Bragg J, Young E et al. Depression as a predictor of mortality and hospitalization among hemodialysis patients in the United States and Europe. Kidney Int 2002; 62: 199-207.Васильева ИА, Михеева ЮС. Качество жизни больных, получающих лечение хроническим ацетатным гемодиализом. Нефрология 2001; 5 (2): 58-63.Васильева ИА, Михеева ЮС. Качество жизни больных, получающих лечение хроническим ацетатным гемодиализом. Нефрология 2001; 5 (2): 58-63.Лебедев BA, Петрова HH, Васильева ИА. Механизмы психологической защиты у больных, находящихся на лечении хроническим гемодиализом. Журн. невропатологии и психиатрии им. Корсакова 1991; 91 (5): 58-62.Лебедев BA, Петрова HH, Васильева ИА. Механизмы психологической защиты у больных, находящихся на лечении хроническим гемодиализом. Журн. невропатологии и психиатрии им. Корсакова 1991; 91 (5): 58-62.

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