School of Public Health, National Defense Medical Center, Taipei, Taiwan.
Res Dev Disabil. 2010 Nov-Dec;31(6):1390-7. doi: 10.1016/j.ridd.2010.06.021. Epub 2010 Jul 29.
The present study aimed to describe the kidney function profile - serum creatinine and estimated glomerular filtration rate (eGFR), and to examine the relationships of predisposing factors to abnormal serum creatinine in people with intellectual disabilities (ID). Data were collected by a cross-sectional study of 827 aged 15-18 years adolescents with ID who participated in annual health examinations as they enrolled into special education schools in Taiwan. We used serum samples to determine participants' creatinine profiles, and the Cockcroft-Gault formula to calculate the data of eGFR to present the chronic kidney disease. The results found 22% of the participants have abnormal serum creatinine value (creatinine>1.0mg/dl) and 59.6%, 36.4% and 4.0% at chronic kidney disease (CKD) stage 1, 2 and 3 cases accordingly based on the Cockcroft-Gault formula. No CKD stage 4 and 5 cases in this study. That is, there were 4% CKD cases (eGFR <60 mL/min/1.73 m(2); CKD stage 3, 4 and 5) in adolescents with ID in this study. The results also indicated that gender and BMI could significantly predict abnormal creatinine condition in multivariate logistic regression analysis. Those boys with ID were more likely to have abnormal creatinine value than girls with ID (OR=10.13, 95% CI=5.96-17.23). In term of BMI, those underweight adolescents with ID were less likely to have high creatinine value compared to normal weight group (OR=0.45, 95% CI=0.28-0.72). In summary, this study provides the preliminary information of creatinine and estimated GFR in people with ID; we suggest the public health policy should initiate appropriate management strategies to monitor kidney function and to improve treatment outcomes of chronic kidney disease for this vulnerable population.
本研究旨在描述肾功能状况 - 血清肌酐和估计肾小球滤过率(eGFR),并探讨智力障碍(ID)患者发生血清肌酐异常的相关因素。这项研究采用横断面设计,对台湾地区 827 名 15-18 岁的 ID 青少年进行了研究,这些参与者在入读特殊教育学校时参加了年度健康检查。我们使用血清样本确定参与者的肌酐谱,并用 Cockcroft-Gault 公式计算 eGFR 的数据,以呈现慢性肾脏病。结果发现,22%的参与者血清肌酐值异常(肌酐>1.0mg/dl),根据 Cockcroft-Gault 公式,分别有 59.6%、36.4%和 4.0%的参与者处于慢性肾脏病(CKD)1、2 和 3 期。本研究中没有 CKD 4 期和 5 期病例。也就是说,在这项研究中,ID 青少年中有 4%的 CKD 病例(eGFR <60 mL/min/1.73 m(2); CKD 3、4 和 5 期)。结果还表明,在多元逻辑回归分析中,性别和 BMI 可以显著预测肌酐异常情况。与 ID 女孩相比,ID 男孩更有可能出现肌酐异常(OR=10.13,95%CI=5.96-17.23)。就 BMI 而言,与正常体重组相比,ID 体重不足的青少年发生高肌酐值的可能性较小(OR=0.45,95%CI=0.28-0.72)。总之,本研究提供了 ID 患者肌酐和估计肾小球滤过率的初步信息;我们建议公共卫生政策应启动适当的管理策略,以监测肾功能,并改善这一弱势群体的慢性肾脏病治疗效果。