Mekahli Djalila, Ledermann Sarah, Gullett Ambrose, Rees Lesley
Renal Unit, Great Ormond St Hospital for Children NHS Trust, Great Ormond St, London, WC1N 3JH, UK.
Pediatr Nephrol. 2014 Aug;29(8):1387-93. doi: 10.1007/s00467-014-2785-8. Epub 2014 Mar 7.
The health related quality of life (HRQoL) of young adults treated for chronic kidney disease (CKD) stage 4/5 from infancy is unknown.
A HRQoL questionnaire was sent to all 41 patients aged >16 years from a previously characterised cohort of infants with CKD stage 4/5 born between 1986 and 1997. Patient scores were compared with a previously reported cohort of patients who needed renal replacement therapy (RRT) in mid childhood and in the normal population.
All patients (11 women) completed the questionnaire at a median (range) age of 19.2 (16.3-23.4) years. At the time of the survey, 5 (12.5 %) were on dialysis, 35 (85.5 %) had a functioning kidney transplant, one (2 %) was still conservatively treated and 22 (54 %) had comorbidities; 68 % were either studying or in paid employment, with 17 % actively seeking employment. Although patients described a lower HRQoL than a healthy, age-matched UK group, in some aspects, scores were comparable with patients needing RRT in later childhood. Lower scores were associated with comorbidities, dialysis at last follow-up, more than one treatment modality change and short stature.
Our survey demonstrates very encouraging results for long-term HRQoL of infants with severe CKD and highlights the negative impact of comorbidities. These data will help clinicians to counsel and inform families.
从婴儿期开始接受慢性肾脏病(CKD)4/5期治疗的年轻成年人的健康相关生活质量(HRQoL)尚不清楚。
向1986年至1997年出生的先前已特征化的CKD 4/5期婴儿队列中的所有41名年龄大于16岁的患者发送了一份HRQoL问卷。将患者得分与先前报告的童年中期需要肾脏替代治疗(RRT)的患者队列以及正常人群进行比较。
所有患者(11名女性)在中位(范围)年龄19.2(16.3 - 23.4)岁时完成了问卷。在调查时,5名(12.5%)正在接受透析,35名(85.5%)有功能正常的肾移植,1名(2%)仍在接受保守治疗,22名(54%)有合并症;68%的人正在学习或有带薪工作,17%的人积极寻找工作。尽管患者描述的HRQoL低于健康的、年龄匹配的英国人群组,但在某些方面,得分与童年后期需要RRT的患者相当。较低的得分与合并症、最后一次随访时的透析、超过一种治疗方式的改变以及身材矮小有关。
我们的调查显示了对于患有严重CKD的婴儿长期HRQoL非常令人鼓舞的结果,并突出了合并症的负面影响。这些数据将有助于临床医生为家庭提供咨询和信息。