COMPARATIVE CHARACTERISTICS OF THE QUALITY OF LIFE OF PATIENTS IN PROGRAM AND PERITONEAL DIALYSIS TAKING INTO ACCOUNT THE PRESENCE OF DIABETES MELLITUS

Renal replacement therapy (RRT) has a significant effect on the patient’s quality of life, adversely affecting his social, psychological and financial well-being. The lives of patients with chronic kidney disease are reorganized and adapted to the changes arising from the nature of the disease and methods of treatment. Moreover, patients depend on the dialysis machine and medical staff. RRT also involves restrictions on exercise, diet, and fluid intake. The aim of the study was to compare the quality of life of patients on program and peritoneal dialysis, and to determine the adherence to the treatment of these patients, taking into account the presence of type 2 diabetes. The study was conducted on the basis of the Center for Nephrology and Dialysis at the Poltava Regional Clinical Hospital. M.V. Sklifosovsky. The study involved 114 patients, of whom 44 were on programmed hemodialysis, 21 – peritoneal and 49, who were in the control group – patients with stage I-II CKD. Hemodialysis patients underwent standard bicarbonate hemodialysis three times a week for 4 hours. In turn, the experimental group (patients on dialysis) was divided into two subgroups: 20 patients (HD1) with diabetes mellitus (DM), 24 – without DM (HD2). The peritoneal dialysis group was also divided into two subgroups: 6 patients – PD1, 15 – PD2. The control group was also divided into two subgroups: 26 patients with DM (KG1) and 23 – without DM (KG2). The SF-36 scale was used to determine quality of life indicators. According to our research, the average indicators of physical functioning, role functioning are slightly higher in patients with HD1 and HD2 compared to patients in groups PD1 and PD2, although the intensity of pain and general health is higher in patients with PD. Physical functioning reflects the degree of physical activity, which limits the performance of physical activity. Between HD2 and KG2 p<0.001, while HD1 and KG1 p≥0.05, respectively. PD1 and KG1 p≤0.005, PD2 and KG2 p<0.001. Role physical functioning indicates the influence of physical condition on daily role activities. No statistically significant difference was found in HD1 and KG1, HD2 and KG2, HD1 and PD1, p>0.05. Significantly significant difference in PD2 and KG2 (p<0.05). Physical and role physical functioning in patients with PD is partially reduced due to the number of sessions per day that occur every 6 hours. On the scale of bodily pain in HD1 and KG1 there is a statistically significant difference p<0.01. Significantly significant difference in PD1 and KG1 (p<0.05). HD2 and KG2 also have a statistically significant difference of p<0.05, PD2 and KG2 p<0.05. The general health scale characterizes the current state of patients and the future. Significantly significant differences were found in both HD1 with KG1 and PD1 with KG1 p≤0.005 and p<0.005, HD2 and KG2, as well as PG2 and KG2 p<0.001. Interestingly, the following 4 scales reflecting mental health are higher in patients with PD than in HD. The scale “vitality” shows a statistically significant difference between HD1 and PD1, p<0.05, HD2 and PD2, p<0.05, HD1 and KG1, PD1 and KG1 p<0.001 and HD2 and KG2, PD2 and KG2 p<0.01. On the scale of “social functioning” statistically significant difference in НD1 and KG1 and PD1 and KG1 p<0.05. No statistically significant difference was found between dialysis groups, p>0.05. On the scale of “role emotional functioning” no reliability was found, p>0.05 in groups HD2 and KG2, PD2 and KG2. No statistically significant difference was found between dialysis groups, p>0.05. The mental health scale characterizes the presence of signs of anxiety and / or depression, signs of positive emotions. There is a statistically significant difference between both HD1 with KG1 and HD2 with KG2, p = 0.01 and p<0.01, respectively. In patients with PD1 and KG1 p<0.001, PD2 and KG2 also p<0.001. No statistically significant difference was found between the dialysis groups, p>0.05, but the average values in patients with PD are higher than in patients with HD. Further study of QOL in the initial examination of patients transferred to renal replacement therapy, assessment of adherence to treatment, as well as signs of anxiety and depressive disorders will allow doctors and medical staff to prevent or reduce the negative effects that may occur during renal replacement therapy