Kidney Function and Disability-Free Survival in Older Women.
Kidney Function and Disability-Free Survival in Older Women.
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老年女性的肾功能和无残疾生存。
DOI：
10.1111/jgs.14433
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发表时间：
2017-01
影响因子：
6.3
通讯作者：
Rifkin DE
中科院分区：
文献类型：
--
作者：
Cavanaugh AM;LaCroix AZ;Kritz-Silverstein D;Rillamas-Sun E;Rifkin DE
研究肾功能与85岁时功能独立生存率与85岁前残疾或死亡率的前瞻性相关性。前瞻性研究妇女健康倡议，在40个美国临床中心进行，1993-1998年期间招募了7，178名绝经后妇女，基线生物标志物评估有可能在2013年9月之前达到85岁。通过根据基线时收集的血清肌酐计算的估计肾小球滤过率（eGFR）测量肾功能。结果包括功能独立的生存至85岁与85岁之前残疾或死亡的生存。残疾定义为通过问卷调查测量的活动和/或日常生活活动限制。22.7%的女性eGFR（mL/min/1.73m2）>90，66.5%为60-89，8.7%为45-59，2.0%<45。中位随访时间为15年。在4，953名幸存者中，3，155人在85岁时没有身体残疾。2225名参与者在85岁之前死亡。与肾功能最差的女性相比（eGFR <45 ml/min/1.73m2），eGFR ≥90的女性有2.71倍（95%CI 1.62 - 4.51），eGFR 60-89的女性为3.04倍（95% CI 1.85 - 5.00），eGFR 45-59的女性生存至85岁且功能独立的几率是85岁之前死亡的2.22倍（95% CI 1.31 - 3.76）。类似的，但稍弱的优势比被视为生存到85岁残疾与85岁之前死亡。与残疾妇女相比，肾功能较好与85岁时独立功能的生存率无显著相关性。与85岁之前死亡相比，肾功能更好与85岁以下的残疾和非残疾生存相关。
To examine the prospective association of kidney function with survival to age 85 with functional independence versus disability or death before age 85. Prospective study Women’s Health Initiative, conducted at 40 U.S. clinical centers 7,178 postmenopausal women enrolled between 1993–1998 with baseline biomarker assessments who had the potential to reach age 85 before September 2013. Kidney function was measured by estimated glomerular filtration rate (eGFR) calculated from serum creatinine collected at baseline. Outcomes included survival to age 85 with functional independence versus survival with disability or death before age 85. Disability was defined as mobility and/or activities of daily living limitations measured by questionnaire. eGFR (mL/min/1.73m2) was >90 in 22.7% of women, 60–89 in 66.5%, 45–59 in 8.7% and <45 in 2.0%. Median follow-up time was 15 years. Among 4,953 survivors, 3,155 reported no physical disability at age 85. 2225 participants died before age 85. Compared to women with the poorest kidney function (eGFR <45 ml/min/1.73m2), women with eGFR ≥90 had 2.71 times (95% CI 1.62 – 4.51), women with eGFR 60–89 had 3.04 times (95% CI 1.85 – 5.00), and women with eGFR 45–59 had 2.22 times (95% CI 1.31 – 3.76) higher odds of survival to age 85 with functional independence relative to death before 85. Similar, but slightly weaker odds ratios were seen for survival to age 85 with disability vs. death before age 85. Better kidney function was not significantly associated with survival to age 85 with independent function when compared to women surviving with disability. Better kidney function was associated with survival to age 85 with and without disability, as compared to death before age 85.