中国慢性肾脏病患者贫血及其与生活质量的关系-来自中国慢性肾脏病队列研究（C-STRIDE）的结果。
Anemia among Chinese patients with chronic kidney disease and its association with quality of life - results from the Chinese cohort study of chronic kidney disease (C-STRIDE).
机构信息
Department of Nephrology, Guizhou Provincial People's Hospital, Guizhou University School of medicine, Gui Yang, China.
Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, No. 8 Xishiku Street, Xicheng District, Beijing, China.
出版信息
BMC Nephrol. 2021 Feb 22;22(1):64. doi: 10.1186/s12882-021-02247-8.
BACKGROUND
Anemia is one of the common complications in patients with chronic kidney disease (CKD). However, there is no systematic investigation on the prevalence of anemia in CKD patients and its relationship with the quality of life in China.
METHODS
The data for this study comes from baseline data from the Chinese Chronic Kidney Disease Cohort Study (C-STRIDE), which recruited predialysis CKD patients in China. The kidney disease quality of life summary (KDQOL-TM) was used to assess health-related quality of life (HRQoL). Use linear regression model to estimate the relationship between hemoglobin level and quality of life.
RESULTS
A total of 2921 patients were included in this study. The adjusted prevalence of hemoglobin (Hb) less than 100 g/L was 10.3% (95% confidence interval [CI]: 9.9,11.4%), and showed an increased trend through reduced eGFR levels from 4.0% (95%CI:2.3,5.9%) in the 45-60 ml/min/1.73m group to 23.4% (95%CI:20.5,26.2%) in the 15-29 ml/min/1.73m group. The prevalence of anti-anemia treatment was 34.0% (95%CI: 28.7,39.3%) and it is shown by reducing eGFR levels from 15.8% (95%CI:0,36.7%) in the 45-60 ml/min/1.73m group to 38.2% (95%CI: 30.7,45.2%) in the 15-29 ml/min/1.73m group. All five dimensions of the KDQOL scores in patients with CKD decreased as hemoglobin declined. After multivariable adjustments,the degrees of decrease became somewhat blunted. For example, compared with hemoglobin of ≥130 g/L, regression coefficients in the hemoglobin of < 100 g/L were - 0.047(95%CI: - 0.049,-0.045) for Symptoms and Problems(S), - 0.047(95%CI: - 0.049,-0.044) for Effects of the Kidney Disease(E), - 0.207(95%CI: - 0.212,-0.203) for Burden of the Kidney Disease(B), - 0.112(95%CI: - 0.115,-0.109) for SF-12 Physical Functioning (PCS), - 0.295(95%CI: - 0.299, -0.292) for SF-12 Mental Functioning (MCS), respectively.
CONCLUSIONS
In our cross-sectional analysis of patients with CKD in China, prevalence of both anemia and anti-anemia treatment increased with decreased eGFR. In addition, anemia was associated with reduced HRQoL.
背景
贫血是慢性肾脏病（CKD）患者的常见并发症之一。然而，中国尚未对 CKD 患者贫血的患病率及其与生活质量的关系进行系统调查。
方法
本研究的数据来自中国慢性肾脏病队列研究（C-STRIDE）的基线数据，该研究招募了中国的透析前 CKD 患者。使用肾脏病生活质量量表（KDQOL-TM）评估健康相关生活质量（HRQoL）。使用线性回归模型估计血红蛋白水平与生活质量之间的关系。
结果
本研究共纳入 2921 例患者。调整后的血红蛋白（Hb）<100g/L 的患病率为 10.3%（95%置信区间[CI]：9.9,11.4%），并随着 eGFR 水平从 45-60ml/min/1.73m 组的 4.0%（95%CI：2.3,5.9%）降至 15-29ml/min/1.73m 组的 23.4%（95%CI：20.5,26.2%）而呈上升趋势。抗贫血治疗的患病率为 34.0%（95%CI：28.7,39.3%），并随着 eGFR 水平从 45-60ml/min/1.73m 组的 15.8%（95%CI：0,36.7%）降至 15-29ml/min/1.73m 组的 38.2%（95%CI：30.7,45.2%）而呈上升趋势。随着血红蛋白的降低，CKD 患者的 KDQOL 评分的所有五个维度均降低。经过多变量调整后，下降程度略有减弱。例如，与血红蛋白≥130g/L 相比，血红蛋白<100g/L 时的回归系数为症状和问题（S）为-0.047（95%CI：-0.049，-0.045），肾脏病影响（E）为-0.047（95%CI：-0.049，-0.044），肾脏病负担（B）为-0.207（95%CI：-0.212，-0.203），SF-12 躯体功能（PCS）为-0.112（95%CI：-0.115，-0.109），SF-12 精神健康（MCS）为-0.295（95%CI：-0.299，-0.292）。
结论
在对中国 CKD 患者的横断面分析中，贫血和抗贫血治疗的患病率均随 eGFR 降低而升高。此外，贫血与 HRQoL 降低有关。
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