Division of Nephrology, Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
Copyright © 2023 Yeungnam University College of Medicine, Yeungnam University Institute of Medical Science
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflicts of interest
No potential conflict of interest relevant to this article was reported.
Funding
None.
Author contributions
Conceptualization, Formal analysis, Methodology, Investigation: SGK, IHL; Data curation, Project administration, Visualization, Software, Validation: SGK; Supervision: IH Lee; Writing-original draft: SGK; Writing-review & editing: SGK, IHL.
Values are presented as number only, mean±standard deviation, or number (%).
ESRD, end-stage renal disease; CGN, chronic glomerulonephritis; CVD, cardiovascular disease; CVA, cerebrovascular accident; CCI, Charlson Comorbidity Index; HD, hemodialysis; BP, blood pressure; SBP, systolic blood pressure; DBP, diastolic blood pressure; Kt/V, urea clearance × time/volume; nPCR, normalized protein catabolic rate; HDL, high-density lipoprotein; LDL, low-density lipoprotein; Na, sodium; K, potassium; Cl, chloride; tCO2, total carbon dioxide; iPTH, intact parathyroid hormone; HbA1c, glycated hemoglobin.
Values are presented as mean±standard deviation.
WHOQOL-BREF, World Health Organization Quality of Life Questionnaire-Brief version; HADS, Hospital Anxiety and Depression Scale; HADS-A, HADS-Anxiety; HADS-D, HADS-Depression; MSPSS, Multidimensional Scale of Perceived Social Support; MoCA, Montreal Cognitive Assessment; PSQI, Pittsburgh Sleep Quality Index.
Variable |
Univariate regression model |
Multivariate regression model 1a) |
Multivariate regression model 2b) |
|||
---|---|---|---|---|---|---|
HR (95% CI) | p-value | HR (95% CI) | p-value | HR (95% CI) | p-value | |
WHOQOL-BREF | ||||||
Physical health domain score, ≤10 | 1.95 (1.02–3.91) | 0.038 | 2.27 (1.02–5.05) | 0.036 | 2.04 (1.02–4.09) | 0.036 |
Psychological domain score, ≤10 | 2.28 (1.14–4.57) | 0.020 | ||||
Social relationship domain score, ≤10 | 1.49 (0.74–2.98) | 0.262 | ||||
Environmental domain score, ≤10 | 1.34 (0.66–2.69) | 0.418 | ||||
Elderly, ≥60 yr | 3.15 (1.48–6.69) | 0.003 | 2.78 (1.28–6.02) | 0.010 | 2.75 (1.27–5.96) | 0.010 |
Male sex | 0.99 (0.51–1.91) | 0.980 | 0.64 (0.31–1.34) | 0.236 | 0.68 (0.33–1.41) | 0.299 |
CCI, ≥4 | 1.52 (0.72–3.24) | 0.276 | 1.40 (0.58–3.35) | 0.457 | 1.62 (0.66–3.95) | 0.289 |
Calcium, <8.7 mg/dL | 2.60 (1.31–5.16) | 0.006 | 3.03 (1.42–6.46) | 0.004 | 2.93 (1.37–6.24) | 0.005 |
Moderate-to-severe cognitive impairment | 1.67 (0.79–3.54) | 0.276 | 1.21 (0.54–2.72) | 0.650 | 1.18 (0.52–2.65) | 0.694 |
HR, hazard ratio; CI, confidence interval; WHOQOL-BREF, World Health Organization Quality of Life Questionnaire-Brief version; CCI, Charlson Comorbidity Index.
a)The result of multiple regression analysis of the patient mortality rate for the physical health domain score of the WHOQOL-BREF. These results were adjusted by male sex, age of ≥60 years, CCI scores of ≥4 points, moderate-to-severe cognitive impairment by Montreal Cognitive Assessment, and serum calcium of <8.7 mg/dL.
b)The result of multiple regression analysis of the patient mortality rate for the psychological domain score of the WHOQOL-BREF. These results were adjusted by male sex, age of ≥60 years, CCI scores ≥4 points, moderate-to-severe cognitive impairment by Montreal Cognitive Assessment, and serum calcium of <8.7 mg/dL.
Variable | Survival | Mortality | Total | p-value |
---|---|---|---|---|
No. of patients | 119 | 41 | 160 | |
Age (yr) | 55.7±11.7 | 65.3±9.5 | 58.2±11.9 | <0.001 |
Male sex | 66 (55.5) | 25 (61.0) | 91 (56.9) | 0.539 |
Body mass index (kg/m2) | 22.1±2.9 | 21.0±2.8 | 21.9±2.9 | 0.038 |
Cause of ESRD | 0.163 | |||
Diabetes mellitus | 63 (52.9) | 26 (63.4) | 89 (55.6) | |
Hypertension | 24 (20.1) | 8 (19.5) | 32 (20.0) | |
CGN | 16 (13.5) | 2 (4.9) | 18 (11.3) | |
Others | 16 (13.5) | 4 (9.8) | 20 (12.5) | |
Diabetes mellitus | 66 (55.5) | 29 (70.7) | 95 (59.4) | 0.057 |
Hypertension | 88 (74.0) | 35 (85.4) | 123 (76.9) | 0.076 |
CVD | 26 (21.9) | 16 (39.0) | 42 (26.3) | 0.024 |
CVA | 17 (14.3) | 8 (19.5) | 25 (15.6) | 0.390 |
Liver disease | 10 (8.4) | 1 (2.4) | 11 (6.9) | 0.203 |
Cancer | 2 (1.7) | 5 (12.2) | 7 (4.4) | 0.004 |
CCI | 3.7±1.3 | 4.4±1.4 | 3.9±1.4 | 0.006 |
HD vintage (mo) | 72.0±37.2 | 66.9±40.3 | 70.7±38.0 | 0.465 |
BP, post HD (mmHg) | ||||
SBP | 136.6±21.4 | 136.8±22.9 | 136.7±21.7 | 0.978 |
DBP | 77.8±11.9 | 71.8±12.2 | 76.3±12.2 | 0.006 |
Kt/V | 1.4±0.5 | 1.4±0.3 | 1.4±0.5 | 0.925 |
nPCR | 0.8±0.2 | 0.8±0.2 | 0.8±0.2 | 0.736 |
White blood cell (/μL) | 5,954±1,850 | 6,230±1,475 | 6,023±1,763 | 0.393 |
Hemoglobin (g/dL) | 10.1±1.1 | 10.2±1.1 | 10.1±1.1 | 0.731 |
Hematocrit (%) | 30.7±3.4 | 30.9±3.4 | 30.8±3.4 | 0.769 |
Platelet (10³/μL) | 176.7±63.2 | 168.1±47.6 | 174.5±59.6 | 0.433 |
Total cholesterol (mg/dL) | 137.4±31.2 | 145.2±39.0 | 139.3±33.4 | 0.203 |
HDL (mg/dL) | 42.5±14.1 | 41.4±10.8 | 42.2±13.3 | 0.644 |
LDL (mg/dL) | 83.8±28.1 | 86.2±27.9 | 84.5±28.0 | 0.651 |
Triglycerides (mg/dL) | 121.6±66.9 | 127.3±84.9 | 123.0±71.6 | 0.665 |
Protein (g/dL) | 6.8±0.6 | 6.8±0.6 | 6.8±0.6 | 0.502 |
Albumin (g/dL) | 4.0±0.4 | 3.8±0.3 | 3.9±0.3 | 0.045 |
Calcium (mg/dL) | 8.9±0.8 | 8.5±0.6 | 8.8±0.8 | 0.014 |
Phosphorus (mg/dL) | 5.6±1.9 | 5.1±2.0 | 5.4±1.9 | 0.159 |
Uric acid (mg/dL) | 6.7±1.6 | 6.9±1.7 | 6.7±1.6 | 0.509 |
Na (mmol/L) | 136.2±3.1 | 135.9±3.0 | 136.1±3.1 | 0.531 |
K (mmol/L) | 5.0±0.9 | 4.9±0.7 | 5.0±0.8 | 0.390 |
Cl (mmol/L) | 95.3±4.2 | 94.7±2.8 | 95.1±3.9 | 0.429 |
tCO2 (mmol/L) | 21.0±3.3 | 20.5±3.1 | 20.9±3.3 | 0.436 |
Ferritin (ng/mL) | 261.8±231.1 | 293.8±255.3 | 269.9±237.0 | 0.463 |
iPTH (pg/mL) | 334.0±314.4 | 274.3±176.4 | 318.9±302.9 | 0.283 |
25-Vitamin D (ng/mL) | 15.8±8.5 | 13.0±7.2 | 15.2±8.3 | 0.082 |
1,25-Vitamin D (ng/mL) | 8.5±4.0 | 7.9±3.1 | 8.4±3.8 | 0.380 |
HbA1C (%) | 7.1±1.8 | 7.1±1.7 | 7.1±1.8 | 0.968 |
C-reactive protein (mg/L) | 4.1±10.4 | 7.7±14.3 | 5.0±11.6 | 0.151 |
Variable | Survival (n=119) | Mortality (n=41) | p-value |
---|---|---|---|
WHOQOL-BREF | |||
Physical health domain | 10.5±2.8 | 9.0±3.1 | 0.009 |
Psychological domain | 10.7±2.8 | 9.3±3.0 | 0.013 |
Social relationship domain | 10.8±3.1 | 10.1±3.3 | 0.254 |
Environmental domain | 11.0±2.5 | 10.0±2.2 | 0.038 |
HADS, total | 14.2±7.2 | 14.6±8.6 | 0.273 |
HADS-A | 5.6±4.0 | 4.7±4.4 | 0.201 |
HADS-D | 8.6±4.2 | 9.9±5.4 | 0.781 |
MSPSS, total | 36.5±10.8 | 35.7±10.9 | 0.523 |
Family | 14.8±4.3 | 15.3±4.2 | 0.433 |
Friends | 10.6±4.6 | 9.9±5.3 | 0.462 |
Significant other | 11.1±4.4 | 10.5±4.7 | 0.695 |
MoCA | 19.9±7.1 | 17.0±8.5 | 0.045 |
PSQI | 7.9±4.5 | 7.8±4.9 | 0.981 |
Variable | Univariate regression model |
Multivariate regression model 1 |
Multivariate regression model 2 |
|||
---|---|---|---|---|---|---|
HR (95% CI) | p-value | HR (95% CI) | p-value | HR (95% CI) | p-value | |
WHOQOL-BREF | ||||||
Physical health domain score, ≤10 | 1.95 (1.02–3.91) | 0.038 | 2.27 (1.02–5.05) | 0.036 | 2.04 (1.02–4.09) | 0.036 |
Psychological domain score, ≤10 | 2.28 (1.14–4.57) | 0.020 | ||||
Social relationship domain score, ≤10 | 1.49 (0.74–2.98) | 0.262 | ||||
Environmental domain score, ≤10 | 1.34 (0.66–2.69) | 0.418 | ||||
Elderly, ≥60 yr | 3.15 (1.48–6.69) | 0.003 | 2.78 (1.28–6.02) | 0.010 | 2.75 (1.27–5.96) | 0.010 |
Male sex | 0.99 (0.51–1.91) | 0.980 | 0.64 (0.31–1.34) | 0.236 | 0.68 (0.33–1.41) | 0.299 |
CCI, ≥4 | 1.52 (0.72–3.24) | 0.276 | 1.40 (0.58–3.35) | 0.457 | 1.62 (0.66–3.95) | 0.289 |
Calcium, <8.7 mg/dL | 2.60 (1.31–5.16) | 0.006 | 3.03 (1.42–6.46) | 0.004 | 2.93 (1.37–6.24) | 0.005 |
Moderate-to-severe cognitive impairment | 1.67 (0.79–3.54) | 0.276 | 1.21 (0.54–2.72) | 0.650 | 1.18 (0.52–2.65) | 0.694 |
Values are presented as number only, mean±standard deviation, or number (%). ESRD, end-stage renal disease; CGN, chronic glomerulonephritis; CVD, cardiovascular disease; CVA, cerebrovascular accident; CCI, Charlson Comorbidity Index; HD, hemodialysis; BP, blood pressure; SBP, systolic blood pressure; DBP, diastolic blood pressure; Kt/V, urea clearance × time/volume; nPCR, normalized protein catabolic rate; HDL, high-density lipoprotein; LDL, low-density lipoprotein; Na, sodium; K, potassium; Cl, chloride; tCO2, total carbon dioxide; iPTH, intact parathyroid hormone; HbA1c, glycated hemoglobin.
Values are presented as mean±standard deviation. WHOQOL-BREF, World Health Organization Quality of Life Questionnaire-Brief version; HADS, Hospital Anxiety and Depression Scale; HADS-A, HADS-Anxiety; HADS-D, HADS-Depression; MSPSS, Multidimensional Scale of Perceived Social Support; MoCA, Montreal Cognitive Assessment; PSQI, Pittsburgh Sleep Quality Index.
HR, hazard ratio; CI, confidence interval; WHOQOL-BREF, World Health Organization Quality of Life Questionnaire-Brief version; CCI, Charlson Comorbidity Index. The result of multiple regression analysis of the patient mortality rate for the physical health domain score of the WHOQOL-BREF. These results were adjusted by male sex, age of ≥60 years, CCI scores of ≥4 points, moderate-to-severe cognitive impairment by Montreal Cognitive Assessment, and serum calcium of <8.7 mg/dL. The result of multiple regression analysis of the patient mortality rate for the psychological domain score of the WHOQOL-BREF. These results were adjusted by male sex, age of ≥60 years, CCI scores ≥4 points, moderate-to-severe cognitive impairment by Montreal Cognitive Assessment, and serum calcium of <8.7 mg/dL.