临床因素对血液透析患者功能表现轨迹的影响。

Effect of clinical factors on trajectory of functional performance in patients undergoing hemodialysis.

机构信息

Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Center of Cancer Program Development, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan.

出版信息

Ren Fail. 2021 Dec;43(1):90-96. doi: 10.1080/0886022X.2020.1852090.

DOI:10.1080/0886022X.2020.1852090

PMID:33349082

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7758042/

Abstract

PURPOSE

This study aimed to investigate the association between clinical factors and temporary changes in functional performance in patients undergoing hemodialysis.

METHODS

This was a retrospective, longitudinal observational study conducted from 2015 to 2017. Eight-two patients undergoing hemodialysis in the outpatient clinic were enrolled. Functional performance was measured using the Karnofsky Performance Status (KPS) scale. Collected data for analysis included demographics, laboratory parameters, and KPS scale scores. All participants were grouped into a high KPS cluster and a low KPS cluster based on dynamic changes in KPS scales from 2015 to 2017.

RESULTS

Participants in the high KPS cluster demonstrated an approximate trend, and those in the low KPS cluster demonstrated a low pattern. By stepwise selection model analysis, age (OR 1.12, 95% CI 1.03-1.23, = 0.011), serum BUN (OR 1.08, 95% CI 1.02-1.16, = 0.015), calcium levels (OR 3.24, 95% CI 1.2-8.73, = 0.02), and beta-2-microglobulin (OR > 1.0, CI >1.00-<1.01, = 0.031) showed risk for the low KPS cluster. Male sex (OR 0.20, 95% CI 0.04-0.96, = 0.045) and albumin level (OR 0.02, 95% CI 0-0.4, = 0.009) showed a low risk for the low KPS cluster.

CONCLUSIONS

A different trajectory pattern was observed between the high and low KPS clusters in a 3-year period. Risk factors for the low KPS cluster were age, serum BUN, calcium, and beta-2-microglobulin levels. Male sex and serum albumin levels reduced the risk for the low KPS cluster.

摘要

目的

本研究旨在探讨接受血液透析患者的临床因素与功能表现暂时变化之间的关联。

方法

这是一项回顾性、纵向观察性研究，于 2015 年至 2017 年进行。共纳入 82 名在门诊接受血液透析的患者。采用卡诺夫斯基绩效状态（KPS）量表评估功能表现。分析中收集的数据包括人口统计学、实验室参数和 KPS 量表评分。所有参与者均根据 2015 年至 2017 年 KPS 量表的动态变化分为高 KPS 组和低 KPS 组。

结果

高 KPS 组的参与者表现出近似趋势，低 KPS 组的参与者表现出低模式。通过逐步选择模型分析，年龄（OR 1.12，95%CI 1.03-1.23， = 0.011）、血清 BUN（OR 1.08，95%CI 1.02-1.16， = 0.015）、钙水平（OR 3.24，95%CI 1.2-8.73， = 0.02）和β-2-微球蛋白（OR > 1.0，CI >1.00-<1.01， = 0.031）显示出低 KPS 组的风险。男性（OR 0.20，95%CI 0.04-0.96， = 0.045）和白蛋白水平（OR 0.02，95%CI 0-0.4， = 0.009）显示出低 KPS 组的低风险。