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ORIGINAL ARTICLES |
Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
Correspondence to: C.C. Szeto, Department of Medicine & Therapeutics,
Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong
Kong,
China.
ccszeto{at}cuhk.edu.hk
Background: Social support is an independent risk
factor for mortality among new hemodialysis patients. We evaluated the effect
of social support on the outcome of Chinese peritoneal dialysis (PD)
patients.
Methods: We studied 167 prevalent PD patients. They
completed the Medical Outcomes Study Social Support Survey, Chinese Version
(MOS-SSS-C) questionnaire. Patients were followed for 1 year. Outcome measures
included change in nutritional status, hospitalization, and technique and
actuarial patient survival.
Results: Actuarial survival was 57.1%, 72.7%, 85.3%,
and 88.6% for MOS-SSS-C total score quartiles I, II, III, and IV, respectively
(log rank test, p = 0.037). Technique survival was 57.1%, 81.9%,
91.9%, and 91.4% (log rank test, p = 0.0044). By multivariate
analysis with the Cox proportional hazard model to adjust for confounders,
every 1 point increase in MOS-SSS-C total score was associated with a 0.6%
[95% confidence interval (CI) 0.2%-0.9%, p = 0.003] reduction in the
risk of death and a 0.5% (95%CI 0.1%-1.0%, p = 0.037) reduction in
the risk of technique failure. The MOS-SSS-C score had no significant effect
on change in nutritional or dialysis adequacy indices, hospitalization, or
number of peritonitis episodes in 1 year.
Conclusion: The degree of social support is an
important predictor of actuarial and technique survival in Chinese PD
patients. Measures to enhance social support may represent an easily
achievable means of improving the clinical outcome of PD patients.
KEY WORDS: Depression; social support; renal failure.
Received 8 May 2007; accepted 25 October 2007.
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