Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Sci Rep. 2019 Dec 20;9(1):19595. doi: 10.1038/s41598-019-56102-w.
The impact of health-related quality of life (HRQOL) on outcomes remains unclear in chronic kidney disease (CKD) patients despite its importance in socioeconomic aspects and individual health. We aim to identify the relationship between HRQOL and progression of CKD in pre-dialysis patients. A total 1622 patients with CKD were analyzed in the KoreaN cohort Study for Outcomes in patients With Chronic Kidney Disease, a prospective cohort study. CKD progression was defined as one or more of the following: initiation of dialysis or transplantation, a two-fold increase in baseline serum creatinine levels, or a 50% decline in the estimated glomerular filtration rate during the follow-up period. The group with CKD progression had lower scores of HRQOL than the group without CKD progression. A fully adjusted Cox proportional hazard ratio model showed that each low baseline physical and mental component summary score was associated with a higher risk of CKD progression. In Kaplan-Meier survival analysis using propensity score matched data, only low physical component summary scores showed statistical significance with CKD progression. Our study highlights low physical component summary score for an important prognostic factor of CKD progression. Risk-modification interventions for high-risk patients may provide benefits to individuals.
尽管健康相关生活质量（HRQOL）在社会经济方面和个人健康方面都很重要，但它对慢性肾脏病（CKD）患者结局的影响仍不清楚。我们旨在确定透析前患者的 HRQOL 与 CKD 进展之间的关系。在韩国慢性肾脏病患者结局的前瞻性队列研究中，对总共 1622 名 CKD 患者进行了分析。CKD 进展的定义为以下一种或多种情况：开始透析或移植、基线血清肌酐水平增加两倍，或在随访期间估计肾小球滤过率下降 50%。与无 CKD 进展的患者相比，CKD 进展组的 HRQOL 评分较低。经过完全调整的 Cox 比例风险比模型显示，每个较低的基线身体和心理成分综合评分与 CKD 进展的风险增加相关。在使用倾向评分匹配数据的 Kaplan-Meier 生存分析中，只有低身体成分综合评分与 CKD 进展具有统计学意义。我们的研究强调了低身体成分综合评分是 CKD 进展的一个重要预后因素。对高危患者进行风险修正干预可能会使个人受益。
