Mobility Impairment in Patients New to Dialysis.
Mobility Impairment in Patients New to Dialysis.
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DOI：
10.1159/000509225
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发表时间：
2020
影响因子：
4.2
通讯作者：
Moe SM
中科院分区：
文献类型：
--
作者：
Moorthi RN;Fadel WF;Cranor A;Hindi J;Avin KG;Lane KA;Thadhani RI;Moe SM
在普遍接受透析的患者中，活动能力受损与功能依赖、虚弱和死亡率有关。在一项为期两年的纵向研究中，我们调查了活动障碍的危险因素，即透析患者的步态速度差，以及步态速度随时间的变化。在透析开始后6个月内登记的183名患者分别在6个月、12个月和24个月后接受随访。在基线时评估握力、健康相关的生活质量和合并症。结果是a)基线步态速度和b)步态速度随时间的变化。通过4米步行评估步态速度。采用多元线性回归分析基线低步速的危险因素。对于纵向分析，使用随时间建模步态速度的线性混合效果建模作为结果。受试者年龄54.7±12.8岁，男性占52.5%，黑人占73.9%，平均透析时间为100.1±46.9d，平均步速为0.78(0.64~0.094)m/S。较低的健康效用和握力、糖尿病肾病和助行器与较低的基线步速相关。1岁时，24%的受试者步速下降0.1m/S。在多变量混合效应模型中，只有年龄、使用助行器、较低的健康效用和较低的握力与步态速度下降显著相关。在我们的透析患者队列中，总体步速非常低，54.2%的受试者在两年内继续失去步速。年龄较大、握力较低和生活质量较低是迟缓的危险因素。步态速度差的风险最高的患者可以在透析开始时被识别出来，以便有针对性地实施治疗方案。
Impaired mobility is associated with functional dependence, frailty and mortality in prevalent patients undergoing dialysis. We investigated risk factors for mobility impairment, (poor gait speed) in patients incident to dialysis, and changes in gait speed over time in a two year longitudinal study. 183 patients enrolled within 6 months of dialysis initiation were followed 6, 12, and 24 months later. Grip strength, health related quality of life and comorbidities were assessed at baseline. Outcomes were a) baseline gait speed and b) change in gait speed over time. Gait speed was assessed by 4-meter walk. Multivariate linear regression was used to identify risk factors for low gait speed at baseline. For longitudinal analyses, linear mixed effects modeling with gait speed modeled over time was used as the outcome. Participants were 54.7±12.8 y, 52.5% men, 73.9% black with mean dialysis vintage of 100.1 ± 46.9 days and median gait speed 0.78 (0.64-.094) m/s. Lower health utility and grip strength, diabetic nephropathy and walking aids were associated with lower baseline gait speed. Loss of 0.1 m/s gait speed occurred in 24% of subjects at 1 year. In multivariate mixed effects models, only age, walking aid use, lower health utility and lower handgrip strength were significantly associated with gait speed loss. In our cohort of incident dialysis patients, overall gait speed is very low and 54.2% of the subjects continue to lose gait speed over two years. Older age, lower handgrip strength and quality of life are risk factors for slowness. Patients at highest risk of poor gait speed can be identified at dialysis initiation to allow targeted implementation of therapeutic options.
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影响因子：
4.5
作者：
Davison, Sara;Jhangri, Gian S.;Feeny, David H.
通讯作者：
Feeny, David H.
DOI：
10.1053/j.ajkd.2015.01.024
发表时间：
2015-08
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Kutner NG;Zhang R;Huang Y;Painter P
通讯作者：
Painter P
影响因子：
3.6
作者：
Horsman J;Furlong W;Feeny D;Torrance G
通讯作者：
Torrance G
影响因子：
4.2
作者：
Delgado, Cynthia;Shieh, Stephanie;Johansen, Kirsten L.
通讯作者：
Johansen, Kirsten L.
影响因子：
39
作者：
Odden, Michelle C.;Peralta, Carmen A.;Pajewski, Nicholas M.
通讯作者：
Pajewski, Nicholas M.