Effects of residual renal function on quality of life in peritoneal dialysis patients

Abstract

Objective To explore the effects of residual renal function (RRF) on quality of life (QOL) in patients with continuous ambulatory peritoneal dialysis (CAPD), and analyze the factors influencing QOL. Methods One hundred and eighteen patients treated with CAPD for at least 3 months in No.455 Hospital of People's Liberation Army were enrolled. All patients were divided into two groups according to residual glomerular filtration rate (rGFR): the group with RRF [rGFR≥1 ml· min-1·(1.73 m2)-1], and the group without RRF [rGFR<1ml·min-1·(1.73 m2)-1]. The demographic characteristics, laboratory data, cardiothoracic ratio, dialysis adequacy parameters, rGFR, blood pressure, urine volume, ultrafiltration volume and dialysis prescription were investigated. Patient's QOL was evaluated by Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Results There was no significant differences between the groups with and without RRF in the age, gender, causes of disease, complication, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), haemoglobin (Hb), cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, normalized protein catabolic rate (nPCR) and cardiothoracic ratio (all P>0.05). Compared with the patients with RRF, PD duration, ultrafiltration volume, serum creatinine (Scr), calcium, phosphorus, C-reactive protein (CRP), parathyroid hormone (PTH) and peritoneal dialysis dose in the patients without RRF were significantly higher, and urine volume, serum albumin (Alb), potassium, and urea total Kt/V were significantly lower (all P 0.05). Simple linear regression showed that there was no correlation between rGFR and SF-36 scores (β=1.330, P=0.070). Multiple linear regression revealed that SF-36 scores were correlated with CRP (β=-0.477, P<0.001), Scr (β=0.020, P<0.001), cardiothoracic ratio (β=-57.823, P=0.004), Alb (β=0.772, P=0.016) and ultrafiltration volume (β=-0.006, P=0.031), but not correlated with rGFR (β=0.099, P=0.302). Conclusions PD patients without and with RRF perceived different scores in physical health, but their scores were similar in mental health and QOL. RRF was no related to QOL in PD patients. Chronic inflammation, fluid overload and malnutrition were the main factors that affect QOL. Key words: Peritoneal dialysis; Quality of life; Residual renal function