维持性血液透析与腹膜透析患者生活质量调查

目的 评估维持性血液透析(MHD)与持续非卧床腹膜透析(CAPD)患者生活质量情况,探讨MHD和CAPD患者生活质量的影响因素.方法 选取2016年7月～9月在郑州大学第一附属医院肾脏内科和血液净化中心随访的118例MHD患者和76例CAPD患者的临床和问卷调查资料.采用KDQOL-SFTM 1.3进行问卷分析,评估MHD与CAPD患者的生活质量.结果 MHD患者KDTA评分为(62.4±11.3)分,SF-36评分为(58.3±17.9)分,明显低于一般人群(P＜0.05).在各分维度评分中11个分维度评分略高于美国,6个分维度评分略高于西班牙;与国内广州调查数据相比,各维度评分均有明显改善,且与沈阳和合肥调查数据持平.CAPD患者KDTA评分为(71.4±8.9)分,SF-36评分为(61.6±16.3)分,明显低于一般人群(P＜0.05).在各分维度评分中7个分维度显著高于中国香港,其余均较中国香港偏低;与国内广州调查数据相比各维度评分均有明显改善,且与沈阳和合肥调查数据持平.MHD患者KDTA和SF-36整体评分显著低于CAPD患者(P＜0.05).在KDTA各分维度评分中,CAPD患者均高于MHD患者,且在肾脏疾病对日常生活的影响(EKD)、肾脏疾病导致的生活负担(BKD)、工作情况(WS)、认知功能(CF)、社交质量(QSI)、性功能(SexF)、社会支持(SoS)、患者满意度(PS)方面差异明显(P＜0.05);在SF-36评分中在生理职能(RP)、躯体疼痛(BP)、总体健康(GH)、情感状况(EWB)、情感职能(RE)各维度中,CAPD组患者均高于MHD患者且差异明显(P＜0.05).对于MHD患者,生活质量在性别、文化程度、家庭年收入、医保情况、原发病因、透析龄方面存在差异(P＜ 0.05),且在SGA评分、血白蛋白(ALB)、血红蛋白(HB)、尿素清除指数(Kt/V)、甲状旁腺激素(iPTH)、钙磷乘积(Ca×P)方面均存在相关性(P＜0.05).透析龄、性别(女)、原发病(糖尿病肾病)、iPTH、Kt/V、SGA评分是影响MHD患者生活质量的独立危险因素;对于CAPD患者,职业状况、医保情况、原发病因、透析龄方面存在差异(P＜0.05),且在SGA评分、ALB、HB、Kt/V方面存在相关性(P＜0.05),原发病(糖尿病肾病)、Kt/V、ALB、SGA评分是影响CAPD患者生活质量的独立危险因素.结论 MHD患者和CAPD患者整体生活质量较低,与发达国家和地区存在差距;CAPD和MHD患者生活质量均受不同因素影响,其中原发病(糖尿病肾病)、Kt/V、SGA评分是共同独立影响因素.     

透析前教育对提高腹膜透析患者生活质量的影响

目的：通过对血肌酐在500-700μmol/L的慢性肾衰竭患者进行透析前教育,研究探讨透析前教育能否提高腹膜透析（PD）后患者的生活质量。方法：80例慢性肾衰竭的患者中,干预组40例和对照组40例,干预组的患者行透析前教育,对照组的患者行常规护理。应用生活质量量表、心理量表等来评估患者的生活质量等情况,所得有效数据应用SPSS13.0软件包进行处理。结果：干预组和对照组PD患者的生活质量有统计学差异（P〈0.05）。结论：加强透析前教育可提高PD患者的生活质量。     

血液透析和腹膜透析患者生活质量比较

目的调查我院维持中心血液透析、腹膜透析治疗患者的生活质量，为临床合理选择治疗方案提供参考。方法对维持目前透析方式6个月以上的中心血液透析、腹膜透析患者，通过查阅病历资料、门诊随诊和问卷调查等方式，调查透析患者现阶段的生活质量（KDQOL～SF）。结果完成病例调查86例，其中血液透析36例，腹膜透析50例。两组患者在性别、年龄、文化程度、付费方式、收入、原发病、透析时间等背景上没有显著差异。腹膜透析组在总体健康、精神健康、情感职能、躯体疼痛以及肾病负担、社交质量、症状与不适、肾病影响、患者满意度等指标得分高于血液透析组。结论腹膜透析患者在生活质量的某些维度上优于血液透析患者，值得进一步推广。     

维持性腹膜透析患者生活质量的研究

目的了解维持性腹膜透析患者的生活质量及其影响因素，为提高患者生活质量提供依据。方法对31例维持性腹膜透析患者，应用生命质量量表(MOS SF-36)、自评抑郁量表(SDS)、家庭功能问卷(Family APGAR)进行测评调查。结果本组维持性腹膜透析患者生活质量的8个维度分。均显著低于一般人群，差异有显著性；生活质量影响因素主要有年龄、性别、透析年限(月)、费用来源、抑郁等。结论根据患者实际情况，采取个体化干预措施，加强患者及家属对抑郁的认知和健康宣教，提高患者生活质量。     

授权教育对居家腹膜透析患者生活质量的影响

目的探讨授权教育对居家腹膜透析患者生活质量的影响。方法采用随机数字表法将64例居家腹膜透析患者分为两组各32例。观察组实施6个月授权教育,对照组采用医院常规健康指导。结果干预6个月后观察组健康教育效果及SF-36健康调查量表中6个维度显著高于对照组（P〈0.05,P〈0.01）。结论授权教育应用于居家腹膜透析患者,可显著提高健康教育效果,改善患者生活质量。     

授权教育对居家腹膜透析患者生活质量的影响

目的探讨授权教育对居家腹膜透析患者生活质量的影响。方法采用随机数字表法将64例居家腹膜透析患者分为两组各32例。观察组实施6个月授权教育,对照组采用医院常规健康指导。结果干预6个月后观察组健康教育效果及SF-36健康调查量表中6个维度显著高于对照组(P0.05,P0.01)。结论授权教育应用于居家腹膜透析患者,可显著提高健康教育效果,改善患者生活质量。     

南京市江宁地区血液透析与腹膜透析患者生活质量比较

目的 调查南京市江宁地区终末期肾病维持性血液透析与腹膜透析患者的生活质量并分析其相关因素.方法 选取江宁地区血液透析35例患者及腹膜透析30例患者,所有患者均检测生化指标、血红蛋白浓度,计算残余肾功能,并调查文化程度;用健康生活质量SF-36量表对维持性透析患者进行生活质量评估,并对生活质量的影响因素进行分析.结果 血液透析患者和腹膜透析患者在健康生活质量SF-36量表各维度得分比较差异无统计学意义(P＞0.05).影响血液透析患者生活质量的因素包括透析龄、血红蛋白浓度、甲状旁腺激素等.影响腹膜透析患者生活质量的因素包括透析龄、文化程度、腹膜透析剂量等.结论 贫血、甲状旁腺机能亢进严重影响终末期肾病透析患者生活质量.除此之外,腹膜透析患者的生活质量还受文化程度、透析剂量、腹透龄的影响.临床工作中应充分考虑上述因素对患者生活质量的影响从而选择适宜的透析质量方式并纠正影响因素以提高患者生活质量.     

宁夏地区不同人群腹膜透析患者生活质量及其影响因素

目的探讨宁夏地区不同人群腹膜透析患者生活质量及其影响因素,旨在为临床工作中如何提高透析患者的生存质量提供依据。方法①选择行规律持续非卧床腹膜透析（continuous ambulatory peritoneal dialysis,CAPD）治疗6个月以上的109例慢性肾衰竭患者。收集患者的民族、年龄、性别、原发病因、受教育程度、年均收入、透析时间、透析方案及体质量指数（body mass index,BMI）等资料。按民族分为回族组和汉族组。②采用肾脏疾病生活质量简表（Medical Outcomes Study Health Status ShortForm,SF-36）评估患者的生活质量。③采用肾脏病膳食改良实验（Modifi—cationofDietinRenalDisease,MDI①）方程估计算患者的肾小球滤过率,以评估患者的残余肾功能。④采用主观综合性营养评估（subjective global assessment,SGA）及白蛋白等指标评估患者营养状况。⑤采用Charlson合并症指数评估患者合并症情况。⑥检测患者血浆全段甲状旁腺素（intactparathy—roidhormone,iPTH）及血钙、血磷水平以评估患者的钙磷代谢状况。结果①回族组、汉族组患者在年龄、性别、原发病因、受教育程度、年均收入、透析时间、透析方案及Charlson合并症指数等均无统计学差异（P〉0．05）。②与汉族组比较,回族组患者血钙、白蛋白、三酰甘油、总胆固醇及肾小球滤过率明显降低,iPTH水平明显升高,差异有统计学意义（P〈0．05）。③与汉族组比较,回族组的SGA评估的营养不良的发生率亦明显升高（47．5Z比24．6％）,有统计学差异（P〈O．05）。④与汉族组比较,回族组在SF-36评分[（52．90±20．68）比（42．78±19．46）]、生理健康评分[（53．27±22．91）比（39．47±20．22）]、精神健康评分E（58．30±22．68）比（46．10±22．76）]均明显下降,有统计学差异（P〈0．05）。⑤与汉族组比较,回族组在情感与精神状况[-（65．29±19．85）比（54．65±21．60）]和疼痛[（72．54±27．88）比（47．19±30．85）]两个维度评分也明显下降,均有统计学差异（P〈0．05）。⑥将2组存在差异的指标进行单因素相关分析及多元线性回归发现,不同人群和白蛋白水平与SF-36相关。结论回族、汉族腹膜透析患者生活质量SF-36、生理健康及精神健康存在一定的差异,回族患者明显低于汉族;白蛋白水平是影响患者生活质量的因素。     

血液透析及腹膜透析患者生活质量评价及相关因素分析

目的：评估血液透析及腹膜透析患者的生活质量及相关影响因素。方法：随机抽取腹膜透析患者28例及血液透析患者28例,采用肾脏疾病生存质量专用量表KDQOL-SFTM量表对透析患者进行生活质量评估。比较血液透析患者和腹膜透析患者健康相关生活质量（HRQOL）的差异,并采用多元回归分析法探索分析透析人群HRQOL的影响因素。结果：血液透析患者和腹膜透析患者在KDQOL-SFTM量表各维度得分上差异无统计学意义,除外社会功能（SF）。血液透析患者SF得分高于腹膜透析患者（63.94±25.08vs48.66±23.41,P〈0.05）。影响血液透析患者生活质量的因素包括：性别、年龄、透析龄、文化程度、钙磷乘积、血红蛋白（Hb）、甲状旁腺激素（PTH）等。上述因素对血液透析患者的HRQOL影响占14.1%～55.6%。影响腹膜透析患者生活质量的因素包括：性别、年龄、透析龄、体重指数（BMI）、糖尿病（DM）、Hb、血白蛋白（Alb）、PTH、铁蛋白、腹透方式、每日交换液量等。上述因素对腹膜透析患者的HRQOL影响占14.7%～58.6%。结论：透析患者的骨矿物质代谢紊乱、贫血严重影响生活质量。除此之外,腹膜透析患者的生活质量还受BMI、DM、营养状态、腹透龄的影响。临床中应积极纠正上述影响因素以提高透析患者的生活质量。     

慢性透析病人的生活质量

慢性透析病人的生活质量汪涛，叶任高，李惠群，杨锦屏，阮玉锯，余立群，朱兰英，沈清瑞，李希杰ＱＵＡＬＩＴＹＯＦＬＩＦＥＩＮＣＨＲＯＮＩＣＤＩＡＬＹＳＩＳＰＡＴＩＥＮＴＳＷａｎｇＴａｏ；ＹｅＲｅｎｇａｏ；ＬｉＨｕｉｑｕｎ；ｅｔａｌ．（ＫｉｄｎｅｙＩｎｓｔ...     

Predictors for quality of life in continuous ambulatory peritoneal dialysis patients

Aim: Peritoneal dialysis patients have diminished quality of life scores compared with healthy subjects. Measures of quality of life have been reported to have a significant predictive value for patient survival and hospitalization in peritoneal dialysis patients. The purpose of this study is to determine the clinical, biochemical and psychological predictors for the quality of life in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: This cross-sectional study included 60 CAPD patients (male/female 33/27; age 45.5 ± 15.7 years, CAPD duration 43.4 ± 32.7 months). Pittsburg Sleep Quality Index was used for assessing sleep quality. We evaluated each patient's depressive symptoms with Beck Depression Inventory (BDI). Quality of life parameters were assessed by the self-administered SF-36 generic health survey questionnaire. In all patients, demographic variables, personality traits and habits, Charlson Comorbidity Index, clinical and laboratory parameters were recorded and analysed. Results: A Pearson bivariate correlation analysis revealed that total quality of life score was negatively correlated with Pittsburg Sleep Quality Index (–0.533, P < 0.0001), BDI (−0.642, P < 0.0001) scores, C-reactive protein (−0.588, P = 0.001), and positively correlated with blood urea nitrogen (0.336, P = 0.02) and albumin (0.351, P = 0.01). BDI scores (β = −0.505, P = 0.001) and the serum albumin levels (β = 0.324, P = 0.009) were the significant independent predictors of quality of life. Conclusion: Poor sleep quality, presence of depression, higher C-reactive protein and lower albumin levels are associated with poorer quality of life. In order to improve life quality in CAPD patients, quality of sleep, depression and nutritional status should be serially evaluated and given appropriate treatment when required.     

Health-related quality of life,depression and mortality in peritoneal dialysis patients in Turkey: seven-year experience of a center

Introduction: Impairment of health-related quality of life (HRQoL) and being in a depressive mood were found to be associated with increased mortality in peritoneal dialysis (PD) patients. We aimed to investigate the association between HRQoL, depression, other factors and mortality in PD patients. Materials and methods: Totally 171 PD patients were included and followed for 7 years in this prospective study. Results: Of 171 PD patients, 45 (26.3%) deceased, 18 (10.5%) maintained on PD, 87 (50.9%) shifted to hemodialysis (HD) and 21 (12.3%) underwent transplantation. The most common cause of death was cardiovascular disease (32, 71.1%) followed by infection (6, 13.3%), cerebrovascular accident (5, 11.2%). The etiology of patients who shifted to HD was PD failure (41, 47.1%), peritonitis (33, 37.9%), leakage (6, 6.9%), catheter dysfunction (3, 3.4%), self willingness (4, 4.6%). Non-survivors were older than survivors (56.6?±?15.0 vs. 43.6?±?14.6, p?=?0.003). There were also statistically significant difference in terms of albumin, residual urine, presence of diabetes and co-morbidity. When the groups were compared regarding HRQoL scores, non-survivors had lower physical functioning (p?<?0.001), role-physical (p?=?0.0045), general health (p?=?0.004), role-emotional (p?=?0.011), physical component scale (PCS) (p?=?0.004), mental component scale (MCS) (p?=?0.029). Age, presence of residual urine, diabetes, albumin, PCS and MCS were entered in regression analysis. Decrease of 1?g/dL of albumin and being diabetic were found to be the independent predictors of mortality. Conclusions: Diabetes and hypoalbuminemia but not HRQOL scores were associated with higher mortality in PD patients after 7 years of following period.     

腹膜透析患者自我调节疲劳与生活质量的纵向研究

目的 探讨腹膜透析患者不同阶段自我调节疲劳及生活质量的动态变化,并分析二者相关性。方法 采用便利抽样法,使用自行设计的患者一般资料调查表、自我调节疲劳量表、肾脏病专用生活质量简表对150例腹膜透析患者在置管后1、3、6、12个月时对其开展追踪调查。结果 患者生活质量处于中等偏低水平且呈逐步下降趋势,自我调节疲劳程度处于中等偏高且呈逐渐上升趋势。置管后1、3、6、12个月患者自我调节疲劳与生活质量呈负相关（均P＜0.05）。结论 腹膜透析患者自我调节疲劳及生活质量呈动态变化,自我调节疲劳水平越低时,其生活质量越高。医护人员应重视患者不同阶段的自我调节疲劳水平,实施个性化的干预指导,降低自我控制资源损耗程度,以提高患者生活质量。     

慢性前列腺炎患者生活质量临床调查

目的调查慢性前列腺炎(chronic prostatitis,CP)患者生活质量及性生活质量状况并分析影响生活质量及性生活质量的相关因素;方法随机选择CP患者,无记名填写CP症状评分量表(NIH-CPSI)、性功能评价表及年龄、病程等,并进行统计分析。结果CP总症状评分5~35分,平均(20.69±7.02)分;生活质量评分2~12分,平均(8.47±2.49)分;性生活质量总分18~53分,平均(38.79±7.55)分;生活质量评分与前列腺炎症状总分、疼痛及排尿症状评分之间有显著相关性;与性功能总评分、射精潜伏期、射精控制能力、性生活满意度、性生活自信度及性生活焦虑评分之间有显著相关性,与年龄、病程、前列腺液内白细胞及卵磷脂数量无显著相关性。结论CP导致生活质量、性生活质量下降,生活质量下降与患者CP症状、性功能下降、性生活满意度降低及配偶性生活满意度降低有关,生活质量及性生活质量下降与年龄、病程及前列腺液内白细胞及卵磷脂数量无明显相关性。     

The incidence of pain and its association with quality of life in patients with peritoneal dialysis

BackgroundThe aims of this study were to investigate the incidence of pain in peritoneal dialysis (PD) patients and to analyze the correlation between pain and quality of life.MethodsPD patients who followed up in our PD center from March 2016 to December 2017 were included. The Short-Form McGill Pain Questionnaire was used to assess pain status. Depression status, sleep quality, quality of life and clinical data were also collected.ResultsA total of 463 PD patients were included, of whom 153 patients (33.1%) with pain. The main cause of pain was calcium and phosphorus metabolism disorder (51.6%). About 101 patients (66.0%) had multiple sites of pain, and 28 patients (18.3%) with pain were treated with analgesic drugs. Binary Logistic regression analysis showed that older age (OR = 1.026; p = 0.032) and higher intact parathyroid hormone level (OR = 1.043; p = 0.040) were independent risk factors for pain in PD patients. Multivariate analysis showed that score of pain rating index was an independent risk factor for depressive symptoms (OR = 1.100; p = 0.015), the score of Pittsburgh sleep quality index (B = 0.005; p = 0.044) and the score of physical component scale (B= −0.727; p = 0.016) in PD patients.ConclusionsThe incidence of pain in PD patients was 33.1%. Older age and higher intact parathyroid hormone level were independent risk factors for pain. Pain was independently associated with depressive symptoms, sleep quality and quality of life in PD patients.     

Important determinants of quality of life in a peritoneal dialysis population in Turkey

Background: Patients' health-related quality of life (HRQoL) is an important indicator for predicting the effectiveness of treatment, morbidity, and mortality. The aim of this study was to determine the level of HRQoL and the most important factors affecting HRQoL in patients receiving peritoneal dialysis (PD). Methods: This cross-sectional study was performed with 156 patients, 30 of whom (19.2%) had automated PD (APD), were over 18 years of age, and were followed up at the Erciyes University Continuous Ambulatory Peritoneal Dialysis (CAPD) Unit during the previous year. HRQoL, depression, and fatigue were measured by means of the Short Form-36 (SF-36), Beck Depression Inventory (BDI), and Fatigue Severity Scale (FSS), respectively. Results: The mean mental component summary (MCS) score was 42.1 ± 11.9 and physical component summary (PCS) score was 39.1 ± 11.2, which was lower than MCS. Depression was the strongest predictor for both diminished mental (β = ?24.4, p < 0.001) and physical (β = ?16.5, p < 0.001) HRQoL. Fatigue was the next strongest predictor for diminished physical HRQoL only (β = ?7.74, p < 0.001). Depression and fatigue accounted for 37% of physical HRQoL impairment. Depression as a sole factor was responsible for 31% of mental HRQoL impairment. Age, hospitalization, total cholesterol, serum albumin levels, and Kt/V urea had affected the SF-36 in some domains score but not in all. Conclusion: HRQoL in our PD patients can be evaluated at a slightly poor level compared to the results of previous studies. Impaired HRQoL is more closely associated with depression and fatigue. Depression was the strongest predictor of both mental and physical HRQoL. Fatigue was the next strongest predictor for physical HRQoL only.     

持续性不卧床腹膜透析及肾移植者生活质量研究

目的 比较持续性不卧床腹膜透析与肾移植术对终末期肾病患者生存质量的影响.方法 选择2011年2月至2012年12月在昆明医科大学第一附属医院和昆明医科大学第二附属医院接受持续性不卧床腹膜透析或肾移植术3个月以上的105例终末期肾病患者,其中54例接受肾移植术[肾移植组,男35例,女19例,平均年龄(39±10)岁],51例接受持续性不卧床腹膜透析[腹膜透析组,男30例,女21例,平均年龄(41±10)岁],采用KDQOL-SFTM 1.2量表对其生存质量进行评估.采用t检验进行数据统计.结果 肾移植组SF-36总分及其分支领域得分(精力状况除外)均显著高于腹膜透析组,差异有统计学意义(P＜0.05).肾移植组KDTA总分、症状、肾病影响、肾病负担、性功能、睡眠及社会支持得分均高于腹膜透析组,差异有统计学意义(P＜0.01),两组工作状况、认知功能、社交质量得分差异无统计学意义.结论 肾移植者的生活质量优于接受维持性腹膜透析者.     

Health status and quality of life reported by incident patients after 1 year on haemodialysis or peritoneal dialysis.

BACKGROUND: It has been suggested that there are no large differences in the quality of life of incident patients starting on haemodialysis (HD) and peritoneal dialysis (PD), but few studies have addressed this issue. METHODS: Association of modality with incident patients' health status and quality of life scores was investigated with propensity score (PS) analysis and also with traditional multivariable regression analyses. We compared patient reported health status and quality of life scores after 1 year of therapy in 455 HD and 413 PD patients who participated in a national study, stayed on the same modality and had complete socio-demographic and clinical information needed to create a PS indicating their expected probability of starting on PD. RESULTS: One year scores on the majority of health status and quality of life measures were not significantly different for HD and PD patients within propensity-matched quintiles. PD patients' scores were higher than HD patients' scores on effects of kidney disease, burden of kidney disease, staff encouragement and satisfaction with care in some quintiles, and traditional regression analyses confirmed that dialysis modality was associated with patients' scores on these variables. CONCLUSIONS: This study provides support for making the choice of PD more widely available as an option to patients initiating chronic dialysis therapy. Patient lifestyle opportunities associated with use of PD, a home-based and self-care therapy, may also apply to home-based HD or in-centre self-care HD. Patients' expectations regarding treatment and their attitudes toward management of their health may interact with treatment modality to shape patient-reported experience on dialysis; this is an important focus for future studies.     

Implementation of a continuous quality improvement program reduces the occurrence of peritonitis in PD

Objective: To investigate the causes of peritonitis in patients with peritoneal dialysis (PD) using continuous quality improvement (CQI) to develop effective interventions and reduce the occurrence of peritonitis. Methods: A quality control team consisting of 10 members, including the department head, four nephrologists and four nurses, all specialized in PD care, and the head nurse, was established at the Peritoneal Dialysis Center of the Third Xiangya Hospital of Central South University. All patients with peritonitis occurring between 1 July 2010 and 31 December 2011 (pre-CQI period) were analyzed and compared with data obtained between January 2012 (implementation of CQI) and March 2013 to investigate possible causes of peritonitis and to develop corresponding interventions. Fishbone analysis, including laboratory parameters, was carried out monthly. Results: Gastrointestinal tract dysfunction, nonstandard procedures and malnutrition were found to be the top three risk factors for peritonitis. Gastrointestinal tract dysfunction was the likely cause of peritonitis in 42.8% of the subjects before CQI and 36.0% after CQI (p?0.05). Nonstandard procedures were the cause of peritonitis in 33.3% of the subjects before CQI and 24.0% after CQI (p?p?0.05). The incidence of Gram-positive bacteria peritonitis reduced from once every 96.9 patients per month before CQI to once every 209.1 patient months after CQI (p?0.05), whereas the incidence of Gram-negative bacteria peritonitis reduced from once every 234.2 patient months before CQI to once every 292.8 patient months after CQI. Conclusion: CQI can effectively reduce the occurrence of PD-related peritonitis.     

血液透析和腹膜透析患者生存质量的多中心调查

目的评估我国广东省南部血液透析(血透)和腹膜透析(腹透)患者生存质量的状况;比较血透和腹透患者生存质量差异;探讨影响血透和腹透患者生存质量的基本因素.方法采取多中心研究方法.病例选自广东省南部,而主要是广州市的9家大医院的维持性血透、腹透3个月以上的患者,其中血透180例,腹透122例.使用KDQOL-SFTM表进行问卷调查,根据Hays RD提供的方法进行评分.结果 (1)血透患者肾脏病和透析相关生存质量(KDTA)总分为51.2±10.6,SF-36总分为48.2±19.9;腹透患者KDTA总分为56.3±12.3,SF-36总分为47.8±16.8.血透多数领域评分较欧美日同类报道为低;腹透仅部分领域低于香港特别行政区,但总体评分与香港特别行政区同类报道无显著差异.(2)比较研究提示腹透总体评分高于血透,但进一步的分层研究提示血透与腹透的生存质量差异主要是在透析的前2年.(3)血透男性患者在KDTA和SF-36及其它5个领域优于血透女性患者;而腹透男女患者之间KDTA和SF-36总分无显著差异.无论男女,腹透患者在多个领域均优于同性别血透患者.(4)血透患者的青年组(＜45岁)与中年组(45～60岁)、老年组(＞60岁)相比,在KDTA和SF-36总体水平无显著差异,仅在体能相关领域高于中老年组.腹透患者青年组在KDTA和SF-36总分以及多个分支领域明显高于中老年组患者,同时,腹透患者在不同年龄组的多个领域优于同年龄段血透患者.(5)在生存质量的总体变化趋势方面,血透患者初始的生存质量较低,透析1～2年时的生存质量逐渐提高,2～4年处于高峰,以后开始下降;腹透患者生存质量的趋势KDTA比较平稳,但2年后SF-36呈明显下降趋势.(6)多元回归分析提示,对KDTA和SF-36总体生存质量的影响因素分别为透析方式、年龄、性别和透析时间.结论 (1)广东省南部,而主要是广州市的血透和腹透患者生存质量状况的总体水平仍低于西方国家和香港特别行政区.(2)慢性肾衰竭患者一体化治疗的前2年可首选腹透.(3)血透和腹透患者的KDTA和SF-36生存质量的趋势不同,腹透不仅适合老年患者,更适合年轻患者和女性患者.(4)透析方式、透析时间、性别和年龄影响透析患者的生存质量,但影响程度和领域各不相同.