National Institute of Health, Department of Cardiovascular, Dysmetabolic and Aging-Associated Diseases, Rome, Italy; Polytechnic University of Marche, Centre of Epidemiology and Biostatistics, Ancona, Italy.
Italian Society of Nephrology, Italy. Division of Nephrology, University of Campania L. Vanvitelli, Naples, Italy.
Arch Gerontol Geriatr. 2019 Jan-Feb;80:46-52. doi: 10.1016/j.archger.2018.10.001. Epub 2018 Oct 12.
Chronic kidney disease (CKD) negatively impacts aging success. This study evaluates the association between CKD and functional disability, defined as limitations in performing mobility tasks, basic (ADLs) and instrumental activities of daily living (IADLs), in a population-based sample of older adults. In particular, we examined whether such a relationship extended to mild-moderate CKD stages (G1-G3ab).
Data from the Cardiovascular risk profile in Renal patients of the Italian Health Examination Survey (CARHES) study were used.Prevalence of CKD was estimated by means of urinary albumin to creatinine ratio (ACR) and eGFR (CKD-EPI equation-enzymatic assay of serum creatinine). A validated questionnaire was used to assess functional limitations. Potentially confounding variables, e.g. socio-demographic features, lifestyles, cardiovascular (CV) risk factors and prevalent CV diseases, were considered.
1309 participants, age 71.4 ± 4.3 years, 53.8% men, were studied. 15.2% of participants were identified as having CKD. Of these, 11.5% were aware of the condition. Prevalence of CKD increased with age, and was similar between men and women. Mild-moderate CKD was found to be significantly associated with disability in mobility (OR = 1.05, 95%CI =1.01-1.09, p = .014) and ADLs/IADLs (OR = 1.06, 95%CI = 1.02-1.12, p = .011) after multiple simultaneous adjustment including socio-demographic variables, CV risk profile, ACR, cognitive impairment and self-rated health.
Mild-moderate CKD independently associated with functional disability in a population-based sample of older adults. Evidence-based recommendations for disability prevention in CKD are needed.
慢性肾脏病（CKD）会对成功老龄化产生负面影响。本研究评估了 CKD 与功能障碍（定义为在执行移动任务、基本日常生活活动（ADL）和工具性日常生活活动（IADL）方面存在限制）之间的关联，该研究基于一个老年人群体的基础样本。特别是，我们研究了这种关系是否扩展到轻度至中度 CKD 阶段（G1-G3ab）。
使用意大利健康检查调查中的肾患者心血管风险概况（CARHES）研究的数据。通过尿白蛋白与肌酐比值（ACR）和 eGFR（CKD-EPI 方程-血清肌酐酶法）估计 CKD 的患病率。使用经过验证的问卷评估功能障碍。考虑了潜在的混杂变量，例如社会人口统计学特征、生活方式、心血管（CV）危险因素和常见的 CV 疾病。
共研究了 1309 名年龄 71.4±4.3 岁、53.8%为男性的参与者。15.2%的参与者被确定为患有 CKD。其中，11.5%的人知晓自己的病情。随着年龄的增长，CKD 的患病率增加，且在男性和女性之间相似。在进行包括社会人口统计学变量、CV 风险概况、ACR、认知障碍和自我报告健康状况在内的多项同时调整后，发现轻度至中度 CKD 与移动（OR=1.05，95%CI=1.01-1.09，p=0.014）和 ADL/IADL（OR=1.06，95%CI=1.02-1.12，p=0.011）的残疾显著相关。
在一个基于人口的老年人群体中，轻度至中度 CKD 与功能障碍独立相关。需要制定针对 CKD 残疾预防的循证建议。
