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高血压对慢性肾病患儿生活质量的影响。

Effect of elevated blood pressure on quality of life in children with chronic kidney disease.

作者信息

Wong Cynthia, Gerson Arlene, Hooper Stephen R, Matheson Matthew, Lande Marc, Kupferman Juan, Furth Susan, Warady Bradley, Flynn Joseph

机构信息

Division of Pediatric Nephrology, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA.

Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

出版信息

Pediatr Nephrol. 2016 Jul;31(7):1129-36. doi: 10.1007/s00467-015-3262-8. Epub 2016 Feb 8.

Abstract

BACKGROUND

Although hypertension is known to have an adverse impact on health-related quality of life (HRQoL) in adults, little is known about the effects of hypertension and use of antihypertensive medications on HRQoL in hypertensive children with chronic kidney disease (CKD).

METHODS

Cross-sectional and longitudinal assessment of impact of elevated blood pressure (BP) and antihypertensive medication use on HRQoL scores obtained in children enrolled in the Chronic Kidney Disease in Children (CKiD) Study. Blood pressure was measured both manually and by ambulatory blood pressure monitoring. HRQoL was assessed with the PedsQL survey.

RESULTS

The study sample included 551 participants with sufficient data for cross-sectional and longitudinal analyses. Cross-sectional analysis of presence of prehypertension or hypertension and impact on HRQoL found mild associations between elevated BP and HRQoL scores with overall PedsQL parent and child scores averaging 79 vs. 76.5 and 83 vs. 78.5, respectively. However, no associations persisted under longitudinal multivariate analysis.

CONCLUSIONS

Despite apparent small effects of elevated BP on HRQoL at baseline, no association was found between the presence of elevated BP and HRQoL over time in children with mild-to-moderate CKD. In addition, antihypertensive medication use did not appear to have an impact on HRQoL in this population.

摘要

背景

尽管已知高血压会对成年人的健康相关生活质量(HRQoL)产生不利影响,但对于高血压及使用抗高血压药物对患有慢性肾脏病(CKD)的高血压儿童的HRQoL的影响却知之甚少。

方法

对参加儿童慢性肾脏病(CKiD)研究的儿童中血压升高(BP)和使用抗高血压药物对HRQoL评分的影响进行横断面和纵向评估。通过手动测量和动态血压监测来测量血压。使用儿童生活质量量表(PedsQL)进行HRQoL评估。

结果

该研究样本包括551名有足够数据进行横断面和纵向分析的参与者。对高血压前期或高血压的存在及其对HRQoL的影响进行横断面分析发现,血压升高与HRQoL评分之间存在轻度关联,PedsQL家长和儿童总体评分分别平均为79对76.5以及83对78.5。然而,在纵向多变量分析中没有关联持续存在。

结论

尽管在基线时血压升高对HRQoL的影响似乎较小,但在轻度至中度CKD儿童中,随着时间推移,血压升高与HRQoL之间未发现关联。此外,在该人群中使用抗高血压药物似乎对HRQoL没有影响。

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