Wang Amanda Y, Bellomo Rinaldo, Cass Alan, Finfer Simon, Gattas David, Myburgh John, Chadban Steve, Hirakawa Yoichiro, Ninomiya Toshiharu, Li Qiang, Lo Serigne, Barzi Federica, Sukkar Louisa, Jardine Meg, Gallagher Martin P
Renal and Metabolic Division, The George Institute for Global Health, Sydney, New South Wales, Australia.
Concord Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Nephrology (Carlton). 2015 Jul;20(7):492-8. doi: 10.1111/nep.12488.
While patients with chronic kidney disease have reduced health-related quality of life (HRQOL), long-term HRQOL of survivors of severe acute kidney injury (AKI) remains unclear.
We analysed HRQOL from the Prolonged Outcomes Study of the Randomized Evaluation of Normal versus Augmented Level Replacement Therapy (POST-RENAL) study and compared findings with those from a general Australian adult population enrolled in the Australian Diabetes, Obesity and Lifestyle (AusDiab) study. We used a multivariate analysis adjusted for baseline characteristics along with sensitivity analysis using age and sex-matched case controls.
In the POST-RENAL study, 282 participants had HRQOL data collected using the SF-12 questionnaire. This was compared with 6330 participants from the AusDiab study. Unadjusted analyses showed that POST-RENAL participants had lower physical component scores (PCS, mean score 40.0 vs 49.8, P<0.0001) and lower mental component scores (MCS, mean score 49.8 vs 53.9, P<0.0001) than the AusDiab group. After age and sex matching, the difference in PCS and MCS remained statistically significant (P<0.0001). Advanced age, reduced renal function and albuminuria (all P ≤ 0.01) were all strongly associated with lower PCS values but not MCS values. After matching subsets of the cohorts on the basis of age, sex and renal function, PCS and MCS were lower in the POST-RENAL group (P<0.0001).
Survivors of severe AKI in the POST-RENAL study had lower physical and mental components of HRQOL compared with general population, even after adjustment for their reduced renal function. Increasing age and reduced renal function were associated with poorer physical QOL.
虽然慢性肾脏病患者的健康相关生活质量（HRQOL）有所下降，但严重急性肾损伤（AKI）幸存者的长期HRQOL仍不明确。
我们分析了正常与强化水平替代治疗随机评估的长期结果研究（POST-RENAL）中的HRQOL，并将结果与纳入澳大利亚糖尿病、肥胖与生活方式（AusDiab）研究的澳大利亚成年普通人群的结果进行比较。我们使用了针对基线特征进行调整的多变量分析以及使用年龄和性别匹配的病例对照的敏感性分析。
在POST-RENAL研究中，282名参与者使用SF-12问卷收集了HRQOL数据。将其与AusDiab研究中的6330名参与者进行比较。未调整分析显示，与AusDiab组相比，POST-RENAL参与者的身体成分得分（PCS，平均得分40.0对49.8，P<0.0001）和心理成分得分（MCS，平均得分49.8对53.9，P<0.0001）较低。在年龄和性别匹配后，PCS和MCS的差异仍具有统计学意义（P<0.0001）。高龄、肾功能减退和蛋白尿（均P≤0.01）均与较低的PCS值密切相关，但与MCS值无关。在根据年龄、性别和肾功能对队列子集进行匹配后，POST-RENAL组的PCS和MCS较低（P<0.0001）。
即使在调整了肾功能减退因素后，POST-RENAL研究中严重AKI的幸存者与普通人群相比，其HRQOL的身体和心理成分仍较低。年龄增长和肾功能减退与较差的身体生活质量相关。
