Section of Nephrology, Department of Medicine, University of Illinois at Chicago and Jesse Brown VA Medical Center, Chicago, IL 60612, USA.
Transl Res. 2012 Jan;159(1):4-11. doi: 10.1016/j.trsl.2011.09.004. Epub 2011 Oct 12.
Health-related quality of life (HRQOL) is poorly understood in patients with chronic kidney disease (CKD) prior to end-stage renal disease. The association between psychosocial measures and HRQOL has not been fully explored in CKD, especially in African Americans. We performed a cross-sectional analysis of HRQOL and its association with sociodemographic and psychosocial factors in African Americans with hypertensive CKD. There were 639 participants in the African American Study of Kidney Disease and Hypertension Cohort Study. The Short Form-36 was used to measure HRQOL. The Diener Satisfaction with Life Scale measured life satisfaction, the Beck Depression Inventory-II assessed depression, the Coping Skills Inventory-Short Form measured coping, and the Interpersonal Support Evaluation List-16 was used to measure social support. The mean participant age was 60 years at enrollment, and men comprised 61% of participants. Forty-two percent reported a household income less than $15,000/year. Higher levels of social support, coping skills, and life satisfaction were associated with higher HRQOL, whereas unemployment and depression were associated with lower HRQOL (P < 0.05). A significant positive association between higher estimated glomerular filtration rate (eGFR) was observed with the Physical Health Composite (PHC) score (P = 0.004) but not in the Mental Health Composite (MHC) score (P = 0.24). Unemployment was associated with lower HRQOL, and lower eGFR was associated with lower PHC. African Americans with hypertensive CKD with better social support and coping skills had higher HRQOL. This study demonstrates an association between CKD and low HRQOL, and it highlights the need for longitudinal studies to examine this association in the future.
健康相关生活质量(HRQOL)在慢性肾脏病(CKD)患者进入终末期肾病之前尚未被充分了解。在 CKD 中,心理社会措施与 HRQOL 之间的关系尚未得到充分探讨,尤其是在非裔美国人中。我们对患有高血压性 CKD 的非裔美国人的 HRQOL 及其与社会人口统计学和心理社会因素的关系进行了横断面分析。非裔美国人肾脏病和高血压队列研究有 639 名参与者。使用简短形式-36 来衡量 HRQOL。迪纳生活满意度量表测量生活满意度,贝克抑郁量表-第二版评估抑郁,应对技能量表-简短形式测量应对,人际关系支持评估清单-16 用于衡量社会支持。参与者的平均年龄为 60 岁,男性占 61%。42%的人报告家庭收入低于 15000 美元/年。更高水平的社会支持、应对技能和生活满意度与更高的 HRQOL 相关,而失业和抑郁与更低的 HRQOL 相关(P<0.05)。较高的估计肾小球滤过率(eGFR)与身体健康综合评分(PHC)呈显著正相关(P=0.004),但与心理健康综合评分(MHC)无关(P=0.24)。失业与较低的 HRQOL 相关,较低的 eGFR 与较低的 PHC 相关。患有高血压性 CKD 的非裔美国人,社会支持和应对技能越好,HRQOL 越高。本研究表明 CKD 与低 HRQOL 之间存在关联,并强调未来需要进行纵向研究来进一步探讨这种关联。