The association of moderate renal dysfunction with impaired preference-based health-related quality of life: third Korean national health and nutritional examination survey.
The association of moderate renal dysfunction with impaired preference-based health-related quality of life: third Korean national health and nutritional examination survey.
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DOI：
10.1186/1471-2369-13-19
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发表时间：
2012-04-24
期刊：
影响因子：
2.3
通讯作者：
Kim DK
中科院分区：
文献类型：
--
作者：
Lee H;Oh YJ;Kim M;Kim H;Lee JP;Kim S;Oh KH;Jun Chin H;Joo KW;Lim CS;Kim S;Kim YS;Kim DK
只有少数大规模研究调查了健康相关生活质量 (HRQOL) 与肾功能之间的关联。此外，医疗保健提供者经常低估中度肾功能不全患者的 HRQOL。本研究评估了韩国成年人群中肾功能对基于偏好的 HRQOL 的影响。我们分析了 2005 年第三次韩国国家健康和营养检查调查中 5,555 名成年人的数据。EuroQol-5D (EQ-5D) 实用评分用于评估 HRQOL。根据估计的肾小球滤过率 (eGFR)，研究对象被分为三组：≥ 90.0、60.0-89.9 和 30.0-59.9 mL/min/1.73 m2。患有晚期肾功能障碍的个体被排除在分析之外。随着 eGFR 的降低，报告 EQ-5D 五个维度中每个维度存在问题的参与者比例显着增加。然而，在 eGFR 为 30.0-59.9 mL/min/1.73 m2 的参与者中，观察到 EQ-5D 效用评分显着下降。在调整年龄、性别、健康相关行为、社会经济和心理变量以及其他合并症后，与 eGFR ≥ 90.0 mL/min/1.73 m2 的参与者相比，eGFR 为 30.0-59.9 mL/min/1.73 m2 的参与者健康效用受损的风险（EQ-5D 效用得分的最低四分位数）几乎高出 1.5 倍。在 EQ-5D 的五个维度中，30.0-59.9 mL/min/1.73 m2 的 eGFR 是自我报告的活动度和疼痛/不适维度问题的独立决定因素。尽管年龄影响肾功能障碍和 EQ-5D 之间的关联，但中度肾功能障碍似乎是一般人群健康效用受损的重要决定因素，并且可能影响健康效用的活动性和疼痛/不适维度。
Only a few large-scale studies have investigated the association between health-related quality of life (HRQOL) and renal function. Moreover, the HRQOL of patients with moderate renal dysfunction is frequently underestimated by healthcare providers. This study assessed the impact of renal function on preference-based HRQOL in Korean adult population. We analyzed data for 5,555 adults from the 3rd Korean National Health and Nutritional Examination Survey 2005. The EuroQol-5D (EQ-5D) utility score was used to evaluate HRQOL. The study subjects were stratified into three groups based on their estimated glomerular filtration rates (eGFRs): ≥ 90.0, 60.0-89.9 and 30.0-59.9 mL/min/1.73 m2. Individuals with advanced renal dysfunction were excluded from the analysis. The proportions of participants who reported problems in each of the five EQ-5D dimensions increased significantly with decreasing eGFR. However, a significant decrease in the EQ-5D utility score was observed among participants with an eGFR of 30.0-59.9 mL/min/1.73 m2. Participants with an eGFR of 30.0-59.9 mL/min/1.73 m2 had an almost 1.5-fold higher risk of impaired health utility (the lowest quartile of EQ-5D utility score) compared with those participants with eGFRs ≥ 90.0 mL/min/1.73 m2, after adjustment for age, gender, health-related behaviors, socioeconomic and psychological variables, and other comorbidities. Among the five dimensions of the EQ-5D, an eGFR of 30.0-59.9 mL/min/1.73 m2 was an independent determinant of self-reported problems in the mobility and pain/discomfort dimensions. Although age affects the association between renal dysfunction and the EQ-5D, moderate renal dysfunction seems to be an important determinant of impaired health utility in a general population and may affect the mobility and pain/discomfort dimensions of health utility.