Sociodemographic, Psychologic Health, and Lifestyle Outcomes in Young Adults on Renal Replacement Therapy
Sociodemographic, Psychologic Health, and Lifestyle Outcomes in Young Adults on Renal Replacement Therapy
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DOI：
10.2215/cjn.04760517
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发表时间：
2017-12-07
影响因子：
9.8
通讯作者：
Ben-Shlomo, Yoav
中科院分区：
文献类型：
--
作者：
Hamilton, Alexander J.;Clissold, Rhian L.;Ben-Shlomo, Yoav
背景和目的接受RRT的年轻人在生活中面临更多的挑战。肾功能衰竭对青年期的影响尚不确定。我们的目的是建立接受RRT的年轻人的社会心理和生活方式的状态。设计，设置，参与者，和测量我们的研究是一个系统的回顾和荟萃分析1630奥尔兹接受RRT与一般人群相比。我们选择了随机对照试验;队列研究;或无语言限制的横断面研究，并提取了社会人口学和生活方式结果的比例，或经验证的心理健康测试，这些测试产生了生活质量，幸福感和自尊得分。结果共纳入60篇文献，共15,575例受试者。研究主要是对儿童移植的单中心横断面研究。与健康同龄人相比，接受RRT的年轻人生活质量较低，透析患者的生活质量更差（7项研究：标准化平均差异，-1.01; 95%置信区间[95% CI]，-1.32至-0.70）与移植患者（9项研究：标准化平均差异，-0.42; 95% CI，-0.64至-0.20）进行比较。他们更有可能失业（7项研究：相对风险，1.89; 95%CI，1.47至2.44）和住在家里（2项研究：相对风险，1.84; 95%CI，1.40至2.43）。他们不太可能结婚或有伴侣（四项研究：相对风险，0.71; 95%CI，0.53至0.95）。高等教育（三项研究：相对风险，1.05; 95%CI，0.73至1.51），戒酒（三项研究：相对风险，1.96; 95%CI，0.84至4.67）和吸烟状况（两项研究：相对风险，0.72; 95%CI，0.36至1.44）没有差异。结果是有限的高异质性和一个小的证据基础，偏向生存patients.Conclusions建立肾功能衰竭与低生活质量的年轻人和有限的就业，独立性和关系相比，健康的同龄人。
Background and objectives Young adults receiving RRT face additional challenges in life. The effect of established kidney failure on young adulthood is uncertain. We aimed to establish the psychosocial and lifestyle status of young adults receiving RRT.Design, setting, participants, & measurements Our study was a systematic review and meta-analysis of 1630-year olds receiving RRT compared with the general population. We selected randomized, controlled trials; cohort studies; or cross-sectional studies without language restriction and extracted proportions of sociodemographic and lifestyle outcomes or validated psychologic health tests producing quality of life, wellbeing, and self-esteem scores. We undertook random effects meta-analysis.Results There were 60 studies with a total of 15,575 participants. Studies were largely single-center cross-sectional studies of those transplanted in childhood. Compared with healthy peers, young adults on RRT had lower quality of life, which was worse for patients on dialysis (seven studies: standardized mean difference, -1.01; 95% confidence interval [95% CI], -1.32 to -0.70) compared with patients with transplants (nine studies: standardized mean difference, -0.42; 95% CI, -0.64 to -0.20). They were more likely to be unemployed (seven studies: relative risk, 1.89; 95% CI, 1.47 to 2.44) and live in the family home (two studies: relative risk, 1.84; 95% CI, 1.40 to 2.43). They were less likely to be married or have a partner (four studies: relative risk, 0.71; 95% CI, 0.53 to 0.95). Higher education (three studies: relative risk, 1.05; 95% CI, 0.73 to 1.51), alcohol abstinence (three studies: relative risk, 1.96; 95% CI, 0.84 to 4.67), and smoking status (two studies: relative risk, 0.72; 95% CI, 0.36 to 1.44) did not differ. Results were limited by high heterogeneity and a small evidence base, biased toward surviving patients.Conclusions Established kidney failure is associated with lower quality of life in young people and limited employment, independence, and relationships compared with healthy peers.