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中度肾功能下降对韩国老年人群与健康相关的生活质量产生负面影响:一项基于人群的研究。

Moderately decreased renal function negatively affects the health-related quality of life among the elderly Korean population: a population-based study.

作者信息

Chin Ho Jun, Song Young Rim, Lee Jae Jung, Lee Suk Beom, Kim Ki Woong, Na Ki Young, Kim Suhnggwon, Chae Dong-Wan

机构信息

Department of Internal Medicine, Seoul National University Bundang Hospital, Gumidong 300, Bundang-Gu, Seong-Nam, Kyeong-Ki Do, 463-707, Korea.

出版信息

Nephrol Dial Transplant. 2008 Sep;23(9):2810-7. doi: 10.1093/ndt/gfn132. Epub 2008 Mar 27.

Abstract

BACKGROUND

The incidence of chronic kidney disease (CKD) is increasing in Korea, especially in the aged population. The health-related quality of life (HRQOL) of patients with chronic renal insufficiency is lower than that for the general population and a lower HRQOL is a predictor of adverse events. We report the impact of kidney function on the HRQOL and the risk factors for poor HRQOL in an elderly population living in one Korean city.

METHODS

This study was conducted as a part of the Korean Longitudinal Study on Health and Aging (KLoSHA) that was designed as a population-based, prospective cohort-study in a population aged >65 years living in a satellite city of Seoul in Korea. Among 1 000 randomly selected subjects, 944 were able to complete the SF-36 questionnaires to measure HRQOL.We categorized the participants into five GFR groups: group 1: 90 mL/min/1.73 m(2) or more, group 2: 89-75 mL/ min/1.73 m(2), group 3: 60-74 mL/min/1.73 m(2), group 4: 45-59 mL/min/1.73 m(2) and group 5: less than 45 mL/min/ 1.73 m(2).

RESULTS

Except for the general health perception and mental health scale, all the other scores of the SF-36 scales showed differences among five groups categorized according to GFR. However, the scores were significantly decreased only among participants with a GFR value of <45 mL/min/1.73 m(2), compared to the other four GFR groups. After adjustment, the physical component summary score was the lowest in participants with GFR values <45 mL/min/1.73 m(2). The dichotomized GFR factor with the criterion of 45 mL/min/1.73 m(2) was an independent predictor of poor physical HRQOL. Other factors, such as age, gender, duration of education, regular exercising habits, depression and a history of cardiovascular accident, were also predictors of HRQOL. A lower haemoglobin level was related to the mental component summary.

CONCLUSION

The renal function deduced to be an important predictor of HRQOL, even in the old age group. The moderately decreased renal function of 45 mL/min/1.73 m(2) GFR was the level at which HRQOL decreased in the elderly Korean population.

摘要

背景

韩国慢性肾脏病(CKD)的发病率正在上升,尤其是在老年人群中。慢性肾功能不全患者的健康相关生活质量(HRQOL)低于普通人群,而较低的HRQOL是不良事件的一个预测指标。我们报告了肾功能对韩国一个城市老年人群HRQOL的影响以及HRQOL较差的危险因素。

方法

本研究作为韩国健康与老龄化纵向研究(KLoSHA)的一部分进行,该研究设计为一项基于人群的前瞻性队列研究,对象为居住在韩国首尔卫星城的65岁以上人群。在1000名随机选择的受试者中,944人能够完成SF-36问卷以测量HRQOL。我们将参与者分为五个肾小球滤过率(GFR)组:第1组:90 mL/(min·1.73 m²)及以上;第2组:89 - 75 mL/(min·1.73 m²);第3组:60 - 74 mL/(min·1.73 m²);第组:45 - 59 mL/(min·1.73 m²);第5组:低于45 mL/(min·1.73 m²)。

结果

除一般健康感知和心理健康量表外,SF-36量表的所有其他得分在根据GFR分类的五组中均显示出差异。然而,与其他四个GFR组相比,仅GFR值<45 mL/(min·1.73 m²)的参与者得分显著降低。调整后,GFR值<45 mL/(min·1.73 m²)的参与者的身体成分总结得分最低。以45 mL/(min·1.73 m²)为标准的二分法GFR因素是身体HRQOL较差的独立预测指标。其他因素,如年龄、性别、教育年限、规律运动习惯、抑郁和心血管意外史,也是HRQOL的预测指标。较低的血红蛋白水平与心理成分总结相关。

结论

即使在老年人群中,肾功能被推断为HRQOL的重要预测指标。GFR为45 mL/(min·1.73 m²)的中度肾功能下降是韩国老年人群HRQOL下降的水平。

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