Factors affecting quality of life in patients undergoing continuous ambulatory peritoneal dialysis: A retrospective analysis

影响接受持续性非卧床腹膜透析患者生活质量的因素:一项回顾性分析

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Abstract

This study aims to evaluate the quality of life (QoL) in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) and to identify key clinical and nutritional factors associated with poor QoL under routine follow-up management. This retrospective study included 164 clinically stable CAPD patients who had been undergoing dialysis for >3 months at a single center. Patients were assessed using the Subjective Global Assessment tool and classified into good or poor QoL groups. Nutritional status was evaluated through anthropometric measurements (body mass index, triceps skinfold thickness, mid-arm circumference, mid-arm muscle circumference), biochemical indicators (albumin, prealbumin, hemoglobin), and dietary intake records. Dialysis adequacy, residual renal function, and microinflammatory markers (CRP) were also analyzed. Logistic regression was used to identify factors independently associated with poor QoL. Among 164 CAPD patients, 88 (53.66%) were classified as having poor QoL based on Subjective Global Assessment, including 78 with mild to moderate malnutrition and 10 with severe malnutrition. Compared to those with good QoL, these patients were older and had significantly lower body mass index, triceps skinfold thickness, mid-arm circumference, serum albumin, prealbumin, hemoglobin, dietary protein intake, and daily energy intake (DEI) (all P < .05). They also showed reduced residual renal function, lower creatinine clearance, and decreased residual urine volume. Elevated C-reactive protein (CRP > 10 mg/L) was more common in the poor QoL group, indicating a higher prevalence of microinflammatory state. The complication rate was significantly higher in this group (88.64 vs 60.53%, P < .01). Logistic regression identified low DEI (OR = 0.808, P = .013) and elevated CRP (OR = 1.259, P = .037) as independent predictors of poor QoL. Malnutrition is highly prevalent among CAPD patients and is closely associated with poor QoL. Inadequate DEI and microinflammatory status were identified as significant independent risk factors for reduced QoL. Regular nutritional assessment and targeted interventions to improve caloric intake and control inflammation may help enhance overall outcomes and reduce complication rates in this population.

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