Quality of life in chronic kidney disease (CKD): A cross-sectional analysis in the renal research institute - CKD study
Quality of life in chronic kidney disease (CKD): A cross-sectional analysis in the renal research institute - CKD study
复制标题
DOI：
10.1053/j.ajkd.2004.12.021
复制
发表时间：
2005-04-01
影响因子：
13.2
通讯作者：
Saran, R
中科院分区：
文献类型：
--
作者：
Perlman, RL;Finkelstein, FO;Saran, R
背景：健康相关生活质量（QOL）是衡量疾病如何影响患者生活的一项重要指标。与健康对照组相比，透析患者的生活质量下降。对于肾脏替代治疗前的慢性肾脏病（CKD）患者的生活质量知之甚少。
方法：采用医学结局研究简表36项（SF - 36）这一标准生活质量测量工具，对参与一项4中心、前瞻性、观察性慢性肾脏病研究的634名患者（平均肾小球滤过率[GFR]为23.6 ± 9.6 mL/min/1.73 m²[0.39 ± 0.16 mL/s/1.73 m²]）进行评估。将这些患者的SF - 36评分与一组血液透析（HD）患者和健康对照组（均来自历史数据）的评分进行比较。在多变量分析中，还分析了生活质量数据与肾小球滤过率以及白蛋白和血红蛋白水平的相关性。
结果：慢性肾脏病患者的SF - 36评分高于一大组血液透析患者（8个维度和2个综合维度的P < 0.0001），但低于美国成年人群的报告评分（8个维度中的7个以及2个综合维度中的1个的P < 0.0001）。慢性肾脏病4期患者的生活质量评分低于慢性肾脏病5期患者，但差异不显著。除疼痛维度外，在所有个体维度和组成维度中，血红蛋白水平与较高的心理和生理生活质量评分呈正相关（P < 0.05）。
结论：与血液透析患者相比，该慢性肾脏病队列的SF - 36评分较高，但低于健康对照组。肾小球滤过率与生活质量无显著相关性。血红蛋白水平可预测SF - 36的生理和心理维度。需要进行纵向研究以确定慢性肾脏病进展过程中生活质量下降的风险期。（2005年，美国国家肾脏基金会版权所有）
Background: Health-related quality of life (QOL) is an important measure of how disease affects patients' lives. Dialysis patients have decreased QOL relative to healthy controls. Little is known about QOL in patients with chronic kidney disease (CKD) before renal replacement therapy. Methods: The Medical Outcomes Study Short Form-36 (SF-36), a standard QOL instrument, was used to evaluate 634 patients (mean glomerular filtration rate [GFR], 23.6 +/- 9.6 mL/min/1.73 m(2) [0.39 +/- 0.16 mL/s/1.73 m(2)]) enrolled in a 4-center, prospective, observational study of CKD. SF-36 scores in these patients were compared with those in a prevalent cohort of hemodialysis (HD) patients and healthy controls (both from historical data). QOL data also were analyzed for correlations with GFR and albumin and hemoglobin levels in multivariable analyses. Results: Patients with CKD had higher SF-36 scores than a large cohort of HD patients (P < 0.0001 for 8 scales and 2 summary scales), but lower scores than those reported for the US adult population (P < 0.0001 for 7 of 8 scales and 1 of 2 summary scales). Patients with CKD stage 4 had lower QOL scores than patients with CKD stage 5, although differences were not significant. Hemoglobin level was associated positively with higher mental and physical QOL scores (P < 0.05) in all individual and component scales except Pain. Conclusion: SF-36 scores were higher in this CKD cohort compared with HD patients, but lower than in healthy controls. GFR was not significantly associated with QOL. Hemoglobin level predicted both physical and mental domains of the SF-36. Longitudinal studies are needed to define at-risk periods for decreases in QOL during progression of CKD. (c) 2005 by the National Kidney Foundation, Inc.