Weber Marc, Faravardeh Arman, Jackson Scott, Berglund Danielle, Spong Richard, Matas Arthur J, Gross Cynthia R, Ibrahim Hassan N
Division of Renal Diseases and Hypertension, University of Minnesota, Minneapolis, Minnesota.
J Am Geriatr Soc. 2014 Oct;62(10):1877-82. doi: 10.1111/jgs.13065. Epub 2014 Oct 3.
To evaluate quality of life (QOL) in kidney transplant recipients aged 65 and older, identify predictors of impaired physical and mental QOL cross-sectionally and compare QOL over time with that of younger transplant recipients and general population controls.
Comparison of serial Medical Outcomes Study 36-item Short-Form Survey (SF-36) QOL scores in transplant recipients aged 65 and older with those of transplant recipients younger than 65 and with those of general population controls from the National Health Measurement Study (NHMS).
University of Minnesota.
Individuals aged 65 and older (n = 150) and younger than 65 (n = 1,544) who received a primary kidney transplant between 1963 and 2009.
Two-sample t-tests and logistic regression were used to assess the risk of significant impairment in physical and mental QOL, defined as 1 standard deviation below the general population norms (<40 points) for the SF-36 Physical (PCS) and Mental Component Subscale (MCS) scores.
PCS scores were 39.3 for transplant recipients aged 65 and older, 43.5 for recipients younger than 65, and 49.2 for NHMS controls (P < .005 for each pairwise comparison). MCS scores were 54.6 for transplant recipients aged 65 and older, 51.0 for recipients younger than 65, and 53.8 for NHMS controls (P < .005 for ≥ 65 vs <65 and NHMS vs <65). These scores did not change significantly from the first (3.6 years after transplant) to the last (6.2 years after transplant) survey. Longer time since transplantation in elderly participants was associated with having significantly impaired physical QOL, but no predictors were associated with significantly impaired mental QOL. In younger recipients, rejection, diabetes mellitus, delayed graft function, coronary artery disease, and longer time on dialysis were associated with impaired physical QOL. Rejection, smoking, diabetes mellitus, and longer time on dialysis were predictors of impaired mental QOL.
Physical QOL is lower in elderly recipients but mental QOL is maintained and is higher than in younger recipients.
评估65岁及以上肾移植受者的生活质量（QOL），横断面识别身体和精神QOL受损的预测因素，并将QOL随时间变化情况与年轻移植受者及一般人群对照进行比较。
比较65岁及以上移植受者、65岁以下移植受者以及来自国家健康测量研究（NHMS）的一般人群对照的连续医学结局研究36项简短调查问卷（SF - 36）QOL评分。
明尼苏达大学。
1963年至2009年间接受初次肾移植的65岁及以上个体（n = 150）和65岁以下个体（n = 1544）。
采用两样本t检验和逻辑回归来评估身体和精神QOL显著受损的风险，身体和精神QOL显著受损定义为SF - 36身体成分量表（PCS）和精神成分量表（MCS）得分低于一般人群标准1个标准差（<40分）。
65岁及以上移植受者的PCS评分为39.3，65岁以下受者为43.5，NHMS对照为49.2（每对比较P <. = 65岁与<65岁以及NHMS与<65岁比较，P <.005）。从首次调查（移植后3.6年）到末次调查（移植后6.2年），这些评分无显著变化。老年参与者移植后时间越长，身体QOL显著受损的可能性越大，但没有预测因素与精神QOL显著受损相关。在年轻受者中，排斥反应、糖尿病、移植肾功能延迟恢复、冠状动脉疾病以及透析时间延长与身体QOL受损相关。排斥反应、吸烟、糖尿病以及透析时间延长是精神QOL受损的预测因素。
老年受者的身体QOL较低，但精神QOL得以维持且高于年轻受者。
