父母健康素养与儿童慢性肾脏病的进展。
Parental health literacy and progression of chronic kidney disease in children.
机构信息
Division of Nephrology, University of Illinois, 820 South Wood Street, 418W CSN, MC 793, Chicago, IL, 60612, USA.
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
出版信息
Pediatr Nephrol. 2018 Oct;33(10):1759-1764. doi: 10.1007/s00467-018-3962-y. Epub 2018 Jun 14.
BACKGROUND
Limited health literacy has been associated with adverse outcomes in children. We evaluated this association in the setting of chronic kidney disease (CKD).
METHODS
We assessed the parental health literacy of 367 children enrolled in the Chronic Kidney Disease in Children (CKiD) Study, using the Short Test of Functional Health Literacy (STOFHLA). We evaluated the association between parental health literacy and CKD progression, defined as time to the composite event of renal replacement therapy (RRT, dialysis, or kidney transplant) or 50% decline in estimated glomerular filtration rate (eGFR).
RESULTS
Median CKiD participant age was 9.5 years, 63% were male, and 59% non-Hispanic white. Median eGFR at baseline was 63 ml/min/1.73 m, and median urine protein-to-creatinine ratio was 0.22. The median STOFHLA score was 98. Over a median follow-up of 3.7 years, the overall CKD progression rate was 2.8 per 100 person-years. After adjustment for demographic and clinical factors, the relative time to CKD progression was 28% longer per 1 SD increase in STOFHLA score (relative time, 95% CI, 1.28, 1.06-1.53).
CONCLUSIONS
In this cohort of children with CKD, higher parental health literacy was associated with a nearly 30% longer time to the composite CKD progression outcome.
背景
有限的健康素养与儿童的不良结局有关。我们在慢性肾脏病（CKD）的背景下评估了这种关联。
方法
我们使用简短的功能性健康素养测试（STOFHLA）评估了 367 名参加慢性肾脏病儿童（CKiD）研究的儿童父母的健康素养。我们评估了父母健康素养与 CKD 进展之间的关系，CKD 进展定义为接受肾脏替代治疗（RRT、透析或肾移植）或估计肾小球滤过率（eGFR）下降 50%的复合事件的时间。
结果
CKiD 参与者的中位年龄为 9.5 岁，63%为男性，59%为非西班牙裔白人。基线时的中位 eGFR 为 63ml/min/1.73m，中位尿蛋白与肌酐比值为 0.22。STOFHLA 评分中位数为 98。在中位随访 3.7 年后，CKD 总体进展率为每 100 人年 2.8 例。在校正人口统计学和临床因素后，STOFHLA 评分每增加 1 个标准差，CKD 进展的相对时间延长 28%（相对时间，95%CI，1.28，1.06-1.53）。
结论
在本队列中患有 CKD 的儿童中，父母健康素养较高与复合 CKD 进展结果的时间延长近 30%相关。
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