肾功能受损与社区居住的老年人群生活质量较低有关：在欧洲老年人中进行 CKD 筛查（SCOPE）研究。
Impaired kidney function is associated with lower quality of life among community-dwelling older adults : The screening for CKD among older people across Europe (SCOPE) study.
机构信息
Department of Nursing, Recanati School for Community Health Professions at the faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-sheva, Israel.
Department of Physical Therapy, Recanati School for Community Health Professions at the faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-sheva, Israel.
出版信息
BMC Geriatr. 2020 Oct 2;20(Suppl 1):340. doi: 10.1186/s12877-020-01697-3.
BACKGROUND
Quality of life (QoL) refers to the physical, psychological, social and medical aspects of life that are influenced by health status and function. The purpose of this study was to measure the self-perceived health status among the elderly population across Europe in different stages of Chronic Kidney Disease (CKD).
METHODS
Our series consisted of 2255 community-dwelling older adults enrolled in the Screening for Chronic Kidney Disease (CKD) among Older People across Europe (SCOPE) study. All patients underwent a comprehensive geriatric assessment (CGA), including included demographics, clinical and physical assessment, number of medications taken, family arrangement, Geriatric Depression Scale (GDS), Cumulative Illness Rating Scale, History of falls, Lower urinary tract symptoms, and Short Physical Performance Battery (SPPB). Estimated glomerular filtration rate (eGFR) was calculated by Berlin Initiative Study (BIS) equation. Quality of life was assessed by Euro Qol questionnaire (Euro-Qol 5D) and EQ-Visual Analogue Scale (EQ-VAS). The association between CKD (eGFR < 60, < 45 ml or < 30 ml/min/1.73m) and low EQoL-VAS was investigated by multivariable logistic regression models.
RESULTS
CKD was found to be significantly associated with low EQoL-VAS in crude analysis (OR = 1.47, 95%CI = 1.16-1.85 for eGFR< 60; OR = 1.38, 95%CI = 1.08-1.77 for eGFR< 45; OR = 1.57, 95%CI = 1.01-2.44). Such association was no longer significant only when adjusting for SPPB (OR = 1.20, 95%CI = 0.93-1.56 for eGFR< 60; OR = 0.87, 95%CI = 0.64-1.18 for eGFR< 45; OR = 0.84, 95%CI = 0.50-1.42), CIRS and polypharmacy (OR = 1.16, 95%CI = 0.90-1.50 for eGFR< 60; OR = 0.86, 95%CI = 0.64-1.16 for eGFR< 45; OR = 1.11, 95%CI = 0.69-1.80) or diabetes, hypertension and chronic obstructive pulmonary disease (OR = 1.28, 95%CI = 0.99-1.64 for eGFR< 60; OR = 1.16, 95%CI = 0.88-1.52 for eGFR< 45; OR = 1.47, 95%CI = 0.92-2.34). The association between CKD and low EQoL-VAS was confirmed in all remaining multivariable models.
CONCLUSIONS
CKD may significantly affect QoL in community-dwelling older adults. Physical performance, polypharmacy, diabetes, hypertension and COPD may affect such association, which suggests that the impact of CKD on QoL is likely multifactorial and partly mediated by co-occurrent conditions/risk factors.
背景
生活质量（QoL）是指受健康状况和功能影响的生活的身体、心理、社会和医学方面。本研究的目的是测量欧洲不同慢性肾脏病（CKD）阶段的老年人群的自我感知健康状况。
方法
我们的研究对象是参加欧洲老年人慢性肾脏病筛查（SCOPE）研究的 2255 名社区居住的老年人。所有患者均接受全面的老年评估（CGA），包括人口统计学、临床和身体评估、服用的药物数量、家庭安排、老年抑郁量表（GDS）、累积疾病评分、跌倒史、下尿路症状和简短体能状况测试（SPPB）。通过柏林倡议研究（BIS）方程计算估计肾小球滤过率（eGFR）。通过欧洲健康问卷（EuroQol 5D）和 EQ-视觉模拟量表（EQ-VAS）评估生活质量。通过多变量逻辑回归模型研究 CKD（eGFR<60、<45ml 或<30ml/min/1.73m）与低 EQoL-VAS 之间的关系。
结果
在粗分析中，发现 CKD 与低 EQoL-VAS 显著相关（eGFR<60 的 OR=1.47，95%CI=1.16-1.85；eGFR<45 的 OR=1.38，95%CI=1.08-1.77；eGFR<30 的 OR=1.57，95%CI=1.01-2.44）。当调整 SPPB（eGFR<60 的 OR=1.20，95%CI=0.93-1.56；eGFR<45 的 OR=0.87，95%CI=0.64-1.18）、CIRS 和多药治疗（eGFR<60 的 OR=1.16，95%CI=0.90-1.50；eGFR<45 的 OR=0.86，95%CI=0.64-1.16）或糖尿病、高血压和慢性阻塞性肺疾病（eGFR<60 的 OR=1.28，95%CI=0.99-1.64；eGFR<45 的 OR=1.16，95%CI=0.88-1.52）时，这种相关性不再显著。在所有剩余的多变量模型中，都证实了 CKD 与低 EQoL-VAS 之间的相关性。
结论
CKD 可能会显著影响社区居住的老年人的生活质量。身体机能、多药治疗、糖尿病、高血压和 COPD 可能会影响这种关联，这表明 CKD 对生活质量的影响可能是多因素的，部分是由并发疾病/危险因素介导的。
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