Kidney function decline and physical function in women
Kidney function decline and physical function in women
复制标题
DOI：
10.1093/ndt/gfn121
复制
发表时间：
2008-09-01
影响因子：
6.1
通讯作者：
Curban, Gary C.
中科院分区：
文献类型：
--
作者：
Lin, Julie;Curban, Gary C.
背景肾功能和身体功能的横断面分析已经确定了晚期肾功能不全患者的生活质量严重受损。然而，目前还没有关于肾功能下降如何与身体功能相关的数据。我们对参加护士健康研究的2544名妇女进行了肾功能下降和身体功能的研究。肾小球滤过率（GFR）采用四变量MDRD方程从1989年和2000年采集的血液中测量的血浆肌酐进行估计。在2000年进行的问卷调查中，通过简表36（SF-36）的身体功能子量表（PFS）评分评估身体功能。PFS评分已被证明与身体功能的直接测量相关。2000年，中位年龄为67岁，中位体重指数（BMI）为25.6 kg/m2，48.5%患有高血压，5.8%患有糖尿病。在1989年至2000年期间，有427名女性（16.8%）经历了eGFR下降>= 25%。2000年eGFR下降≥ 25%的患者的中位PFS为80分，而没有下降的患者的PFS评分为85分（P < 0.001）。在完全校正的模型中，eGFR下降≥ 25%与PFS评分降低3.5分独立相关（95%CI-5.4至-1.5）。此外，eGFR下降≥ 25%与PFS评分最低四分位数的优势比增加独立相关（OR 1.37; 95%CI 1.04-1.81）。我们得出结论，eGFR下降>= 25%超过11年是独立与较低的身体功能的妇女。
Background. Cross-sectional analyses of kidney function and physical function have identified profound quality of life impairments in people with advanced kidney dysfunction. No data are currently available, however, on how kidney function decline may be associated with physical function.Methods. We undertook a study of kidney function decline and physical function in 2544 women participating in the Nurses' Health Study. Glomerular filtration rates (GFR) were estimated using the four-variable MDRD equation from plasma creatinine measured in blood collected in 1989 and 2000. Physical function was assessed by the Physical Function Sub-Scale (PFS) score of the Short Form 36 (SF-36) in a questionnaire administered in the year 2000. PFS scores have been shown to correlate well with direct measures of physical function.Results. In the year 2000, the median age was 67 years, median body mass index (BMI) was 25.6 kg/m(2), 48.5% had hypertension and 5.8% had diabetes. There were 427 women (16.8%) who experienced an >= 25% decline in eGFR between 1989 and 2000. Median PFS in 2000 for those with an eGFR decline of >= 25% was 80 compared to a PFS score of 85 for those without (P < 0.001). In fully adjusted models, the presence of an eGFR decline of >= 25% was independently associated with a 3.5-point lower PFS score (95% CI -5.4 to -1.5). Also, an eGFR decline of >= 25% was independently associated with an increased odds ratio of being in the lowest quartile of PFS score (OR 1.37; 95% CI 1.04-1.81).Conclusions. We conclude that an eGFR decline of >= 25% over 11 years is independently associated with lower physical function in women.