Schnelle John, Osterweil Dan, Globe Denise, Sciarra Angela, Audhya Paul, Barlev Arie
Center for Quality Aging, Vanderbilt University Medical Center, Nashville, TN 37232-2400, USA.
J Am Med Dir Assoc. 2009 Feb;10(2):120-6. doi: 10.1016/j.jamda.2008.08.012. Epub 2008 Dec 20.
The aim of this study was to evaluate the potential association between anemia associated with chronic kidney disease (CKD) and the ability for older nursing home (NH) residents with these conditions to perform basic activities of daily living (ADL).
This is a multicenter, retrospective, observational study utilizing data abstracted from medical charts, laboratory records, and Minimum Data Set (MDS) records from the 1-year period before the date of data abstraction.
24 NHs in the United States.
Older (>or=65 years of age) NH residents with CKD (not receiving dialysis) who were not comatose and were alive as of the day of data abstraction were included in this analysis.
Resident demographics, hemoglobin, and estimated glomerular filtration rate records, and ADL items were abstracted from the medical charts, laboratory records, and MDS. The prevalence of CKD and anemia associated with CKD was evaluated from laboratory records. The relationship between CKD, anemia, and ADLs was assessed through a repeated resampling (bootstrap) analysis.
CKD was present in 45.7% of the residents. Of these, 60.5% had anemia. Residents with CKD and anemia were more likely to require limited or extensive assistance in performing ADLs such as bed mobility, transfer, walk in room, walk in corridor, locomotion on unit, dressing, and toilet use. Conversely, a greater proportion of residents with CKD but without anemia required no or slight supervision in performing these ADLs.
CKD and anemia associated with CKD are common in older NH residents. The data suggest that older NH residents with CKD and anemia require greater assistance in performing ADLs than residents with CKD alone. These data support the importance of evaluating the older NH population for CKD and anemia. As with all retrospective analyses, study limitations must be considered in the interpretation of these results.
本研究旨在评估慢性肾脏病（CKD）相关贫血与患有这些疾病的老年疗养院（NH）居民进行日常生活基本活动（ADL）能力之间的潜在关联。
这是一项多中心、回顾性观察研究，利用从数据提取日期前1年的病历、实验室记录和最低数据集（MDS）记录中提取的数据。
美国24家NH。
纳入分析的是年龄≥65岁、患有CKD（未接受透析）、未昏迷且在数据提取当天仍存活的老年NH居民。
从病历、实验室记录和MDS中提取居民人口统计学信息、血红蛋白和估计肾小球滤过率记录以及ADL项目。通过实验室记录评估CKD及与CKD相关贫血的患病率。通过重复重采样（自助法）分析评估CKD、贫血与ADL之间的关系。
45.7%的居民患有CKD。其中，60.5%患有贫血。患有CKD和贫血的居民在进行如床上活动、转移、室内行走、走廊行走、病房内移动、穿衣和使用厕所等ADL时更有可能需要有限或广泛的帮助。相反，患有CKD但无贫血的居民中，更大比例的人在进行这些ADL时不需要或只需轻微监督。
CKD及与CKD相关的贫血在老年NH居民中很常见。数据表明，患有CKD和贫血的老年NH居民在进行ADL时比仅患有CKD的居民需要更多帮助。这些数据支持了对老年NH人群进行CKD和贫血评估的重要性。与所有回顾性分析一样，在解释这些结果时必须考虑研究局限性。
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