Quality of life and long-term cardiovascular survival of patients on hemodialysis
Abstract
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.
About the Authors
Vladimir A. Dobronravov
Research Institute of Nephrology, Scientific and Clinical Research Centre, Pavlov First Saint-Petersburg State Medical University; Pavlov First Saint-Petersburg State Medical University
Russian Federation
Russian Federation
Irina A. Vasilieva
Research Institute of Nephrology, Scientific and Clinical Research Centre, Pavlov First Saint-Petersburg State Medical University
Russian Federation
Russian Federation
Elena V. Babarykina
Omsk Regional Clinical Hospital
Russian Federation
Russian Federation
References
1. Смирнов АВ. Системный подход к анализу кардиоренальных взаимоотношений как первый шаг на пути к нефрологии формата П4. Нефрология 2011; 15(2): 11-19
2. Auffray C, Charron D, Hood L. Predictive, preventive, personalized and participatory medicine: back to the future. Genome med 2010; 2 (8): 57
3. Васильева ИА, Добронравов ВА, Панина ИЮ и др. Качество жизни больных на различных стадиях хронической болезни почек. Нефрология 2013; 17 (2): 60-65
4. USRDS Annual Data Report 2015. Volume 2 - ESRD in the United States, Chapter 9: Cardiovascular Disease in Patients With ESRD: http://www.usrds.org/2015/download/vol2_09_CVD_15.pdf
5. Da Silva-Gane M, Wellsted D, Greenshields H et al. Quality of life and survival in patients with advanced kidney failure managed conservatively or by dialysis. Clin J Am Soc Nephrol 2012; 7 (12): 2002-2009
6. Hayashino Y., Fukuhara S, Akiba T et al. Low health-related quality of life is associated with all-cause mortality in patients with diabetes on haemodialysis: the Japan Dialysis Outcomes and Practice Pattern Study. Diabet Med 2009; 26 (9): 921-927
7. Peng YS, Chiang CK, Hung KY et al. Are both psychological and physical dimensions in health-related quality of life associated with mortality in hemodialysis patients: a 7-year Taiwan cohort study. Blood Purif 2010; 30 (2): 98-105
8. Lacson E Jr, Xu J, Lin SF et al. A comparison of SF-36 and SF-12 composite scores and subsequent hospitalization and mortality risks in long-term dialysis patients. Clin J Am Soc Nephrol 2010; 5 (2): 252-260
9. Lopez Revuelta K, Garcia Lopez FJ, de Alvaro Moreno F, Alonso J. Perceived mental health at the start of dialysis as a predictor of morbidity and mortality in patients with end-stage renal disease (CALVIDIA Study). Nephrol Dial Transplant 2004; 19 (9): 2347-2353
10. Jhamb M, Pike F, Ramer S et al. Impact of fatigue on outcomes in the hemodialysis (HEMO) study. Am J Nephrol 2011; 33 (6):515-523
11. Untas A, Thumma J, Rascle N et al. The associations of social support and other psychosocial factors with mortality and quality of life in the dialysis outcomes and practice patterns study. Clin J Am Soc Nephrol 2011; 6 (1):142-152
12. 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
13. 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
14. Бабарыкина ЕВ, Васильева ИА, Смирнова ЛМ, Добронравов ВА. Качество жизни и выживаемость больных молодого возраста, находящихся на лечении хроническим гемодиализом. Нефрология 2003; 7 (2): 41-45
15. Feroze U, Noori N, Kovesdy CP et al. Quality-of-life and mortality in hemodialysis patients: roles of race and nutritional status. Clin J Am Soc Nephrol 2011; 6 (5): 1100-1111
16. Mapes DL, Lopes AA, Satayathum S et al. Health-related quality of life as a predictor of mortality and hospitalization: The Dialysis Outcomes and Practice Patterns Study (DOPPS). Kidney Int 2003; 64 (1): 339-349
17. den Hoedt CH, Bots ML, Grooteman MP et al. Should we still focus that much on cardiovascular mortality in end stage renal disease patients? The CONvective TRAnsport STudy. PLoS One 2013; 8 (4): e61155. doi: 10.1371/journal.pone.0061155
18. Kang EW, Pike F, Ramer S et al. The association of mental health over time with cardiac outcomes in HEMO study patients. Clin J Am Soc Nephrol 2012; 7 (6): 957-964
19. Boulware LE, Liu Y., Fink NE et al. Temporal relation among depression symptoms, cardiovascular disease events, and mortality in end-stage renal disease: contribution of reverse causality. Clin J Am Soc Nephrol 2006; 1 (3): 496-504
20. Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey: Manual and Interpretation Guide. The Health Institute, New England Medical Center, Boston, MA., 1993; 3-320
21. Varshavsky S, Gandek B, Petrova N, Vasilieva I. Translation of a quality of life questionnaire: first experience in Russia. Qual Life Res 1995; 4 (5): 498-499
22. Ware JE. SF-36 Health Survey Update. Spine 2000; 25 (24): 3130-3139
23. Grassi M, Nucera A. European Community Respiratory Health Study Quality of Life Working Group. Dimensionality and summary measures of the SF-36 v1.6: comparison of scale- and item-based approach across ECRHS II adults population. Value Health 2010; 13(4): 469-478. doi: 10.1111/j.1524-4733.2009.00684.x
24. Hobart J, Freeman J, Lamping D et al. The SF-36 in multiple sclerosis: why basic assumptions must be tested. J Neurol Neurosurg Psychiatry 2001; 71 (3): 363-370
25. Васильева ИА, Добронравов ВА, Бабарыкина ЕВ. Субъективные показатели физического здоровья связаны с выживаемостью больных на гемодиализе. Нефрология и диализ 2008; 10 (2): 134-139
26. Добронравов ВА, Васильева ИА, Бабарыкина ЕВ. Физическое функционирование как предиктор отдаленной общей выживаемости больных на хроническом гемодиализе. Нефрология 2015; 19 (1): 54-60
27. Tsai MH, Liou HH, Leu JG et al. Sites of peripheral artery occlusive disease as a predictor for all-cause and cardiovascular mortality in chronic hemodialysis. PLoS One 2015; Jun 2; 10(6): e0128968. doi: 10.1371/journal.pone.0128968
28. Losito A, Del Vecchio L, Del Rosso G, Locatelli F Post-dialysis Hypertension: Associated Factors, Patient Profiles, and Cardiovascular Mortality. Am J Hypertens 2015; Sep 21. pii: hpv162. [Epub ahead of print]
29. Feng SJ, Li H, Wang SX. Lower Hydrogen Sulfide Is Associated with Cardiovascular Mortality, Which Involves cPKCßII/ Akt Pathway in Chronic Hemodialysis Patients. Blood Purif 2015; 40 (3):260-269. doi: 10.1159/000439580
30. Solak Y, Yilmaz MI, Siriopol D et al. Serum neutrophil gelatinase-associated lipocalin is associated with cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol 2015; 47 (12): 1993-2001. doi: 10.1007/s11255-015-1136-4
31. Iwamoto N, Sato N, Nishida M et al. Low parathyroid hormone levels after parathyroidectomy reduce cardiovascular mortality in chronic hemodialysis patients. Clin Exp Nephrol 2015 Dec 17. [Epub ahead of print]
32. Ritz E, Bommer J. Cardiovascular problems on hemodialysis: current deficits and potential improvement. Clin J Am Soc Nephrol 2009; 4 Suppl 1: S71-S78
33. de Jager DJ, Grootendorst DC, Jager KJ et al. Cardiovascular and non cardiovascular mortality among patients starting dialysis. JAMA 2009; 302 (16): 1782-1789
34. Ртищева ОВ, Калев ОФ, Ахматов ВЮ. Структура причин летальных исходов у больных, находившихся на программном гемодиализе. Клин нефрология 2011; 1: 43-45
35. Васильева ИА. Качество жизни больных при лечении гемодиализом: биологические и психосоциальные факторы, методы оценки и подходы к коррекции: Автореф. дис.. д-ра психол. наук. СПб., 2010. 45
36. Parkerson GR, Gutman RA. Health-related quality of life predictors of survival and hospital utilization. Health Care Financ Rev 2000; 21 (3): 171-184
Review
For citations:
Dobronravov V.A., Vasilieva I.A., Babarykina E.V. Quality of life and long-term cardiovascular survival of patients on hemodialysis. Nephrology (Saint-Petersburg). 2016;20(3):78-84. (In Russ.)
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