Исходы хронической болезни почек с точки зрения пациента

В обзоре приведено определение понятия «исходы с точки зрения пациента» (patient-reported outcomes – PRO). К основным компонентам PRO относят качество жизни (КЖ), связанное со здоровьем; симптоматику, оцениваемую пациентом; функциональный статус; удовлетворенность лечением. Представлено описание наиболее часто применяемых опросников для оценки КЖ пациентов с хронической болезнью почек (ХБП). Показано, что на додиализных стадиях ХБП страдает, в первую очередь, физическая составляющая КЖ. По мере прогрессирования ХБП снижаются суммарный показатель физического здоровья опросника SF-36, а также оценки шкал физического функционирования, влияния физического здоровья на повседневную деятельность, боли, общего здоровья. Из специфических для ХБП шкал КЖ отмечается ухудшение оценок шкал «симптомы/проблемы», «бремя заболевания почек», «влияние заболевания почек на повседневную деятельность». Убедительных данных в пользу снижения показателей психосоциальной компоненты КЖ у больных с ХБП в литературе не представлено. В обзоре приведено определение понятия «всесторонняя консервативная помощь», предложенное экспертами, присутствовавшими на состоявшейся в 2013 году Согласительной конференции KDIGO по поддерживающей помощи. Показано, что всесторонняя консервативная помощь может быть достаточно эффективным методом выбора для пожилых пациентов с 5-й стадией ХБП. Продемонстрировано, что снижение суммарного показателя физического здоровья опросника SF-36 независимо ассоциировано с прогрессированием ХБП и повышением риска смерти. Вместе с тем, исследования КЖ пациентов с ХБП додиализных стадий немногочисленны. Сопоставимость данных затруднена вследствие использования различных опросников для оценки КЖ. Практически отсутствуют рандомизированные клинические исследования, что снижает ценность полученных результатов.

исходы с точки зрения пациента, качество жизни, хроническая болезнь почек, SF-36, KDQOL-SF, KDQOL-36, всесторонняя консервативная помощь, выживаемость

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