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Том 24 №3 2022 год - Нефрология и диализ

Факторы, ассоциированные с качеством жизни на додиализных стадиях хронической болезни почек. Обзор литературы

Васильева И.А.

DOI: 10.28996/2618-9801-2022-3-457-472

Аннотация: Качество жизни, связанное со здоровьем, является одним из основных «исходов с точки зрения пациента» (patient-reported outcomes). Мониторинг качества жизни пациентов с хронической болезнью почек (ХБП) можно рассматривать как один из подходов к внедрению принципов персонализированной медицины в клиническую нефрологию. В обзоре приведено краткое описание опросников, наиболее часто используемых для оценки качества жизни пациентов с ХБП, обобщены результаты исследований факторов, связанных с качеством жизни на додиализном этапе лечения. Принято выделять социально-демографические, клинические и психологические факторы, ассоциированные с качеством жизни, связанным со здоровьем. Показано, что принадлежность к женскому полу, табакокурение, низкий уровень образования и дохода, наличие сердечно-сосудистой патологии, депрессии и тревоги сопряжены со снижением качества жизни пациентов на додиализных стадиях ХБП. В отношении других клинических и социально-демографических показателей данные литературы не столь однозначны. Так, по результатам большинства исследований, наличие сахарного диабета, снижение скорости клубочковой фильтрации, уровней альбумина и гемоглобина и увеличение возраста и уровня креатинина негативно сказывались на параметрах физической составляющей качества жизни. В то же время, в значительном числе исследований не была установлена связь этих показателей с параметрами психосоциальной составляющей качества жизни, что объясняют зависимостью этой компоненты качества жизни, в первую очередь, от характеристик эмоционального состояния и личности. Из числа психологических факторов, ассоциированных с качеством жизни пациентов с ХБП на этапе консервативного лечения, внимание исследователей привлекал главным образом уровень депрессии. Лишь единичные работы посвящены анализу других психологических переменных (личностных черт, стратегий преодоления трудностей, эффекта психосоциальных интервенций), связанных с качеством жизни пациентов с ХБП на консервативной терапии. Выявление и систематизация потенциально модифицируемых факторов качества жизни задают направления для работы с больными в плане профилактики и коррекции сниженного качества жизни.

Для цитирования: Васильева И.А. Факторы, ассоциированные с качеством жизни на додиализных стадиях хронической болезни почек. Обзор литературы. Нефрология и диализ. 2022. 24(3):457-472. doi: 10.28996/2618-9801-2022-3-457-472

Весь текст

Ключевые слова: хроническая болезнь почек, качество жизни, факторы, SF-36, KDQOL-SF, KDQOL-36, chronic kidney disease, quality of life, factors, SF-36, KDQOL-SF, KDQOL-36

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