Farragher Janine F, Zhang Jianguo, Harrison Tyrone G, Ravani Pietro, Elliott Meghan J, Hemmelgarn Brenda
Department of Community Health Sciences, University of Calgary, AB, Canada.
Department of Medicine, University of Calgary, AB, Canada.
Can J Kidney Health Dis. 2021 Mar 16;8:20543581211001224. doi: 10.1177/20543581211001224. eCollection 2021.
Fatigue is a pervasive symptom among patients with chronic kidney disease (CKD) that is associated with several adverse outcomes, but the incidence of hospitalization for fatigue is unknown.
To explore the association between estimated glomerular filtration rate (eGFR) and incidence of hospitalization for fatigue.
Population-based retrospective cohort study using a provincial administrative dataset.
Alberta, Canada.
People above age 18 who had at least 1 outpatient serum creatinine measurement taken in Alberta between January 1, 2009, and December 31, 2016.
The first outpatient serum creatinine was used to estimate GFR. Hospitalization for fatigue was identified using International Classification of Diseases, Tenth Revision (ICD-10) code R53.x.
Patients were stratified by CKD category based on their index eGFR. We used negative binomial regression to determine if there was an increased incidence of hospitalization for fatigue by declining kidney function (reference eGFR ≥ 60 mL/min/1.73m). Estimates were stratified by age, and adjusted for age, sex, socioeconomic status, and comorbidity.
The study cohort consisted of 2 823 270 adults, with a mean age of 46.1 years and median follow-up duration of 6.0 years; 5 422 hospitalizations for fatigue occurred over 14 703 914 person-years of follow-up. Adjusted rates of hospitalization for fatigue increased with decreasing kidney function, across all age strata. The highest rates were seen in adults on dialysis (adjusted incident rate ratios 24.47, 6.66, and 3.13 for those aged 18 to 64, 65 to 74, and 75+, respectively, compared with eGFR ≥ 60 mL/min/1.73m).
Fatigue hospitalization codes have not been validated; reference group limited to adults with at least 1 outpatient serum creatinine measurement; remaining potential for residual confounding.
Declining kidney function was associated with increased incidence of hospitalization for fatigue. Further research into ways to address fatigue in the CKD population is warranted.
Not applicable (not a clinical trial).
疲劳是慢性肾脏病（CKD）患者中普遍存在的症状，与多种不良后果相关，但因疲劳住院的发生率尚不清楚。
探讨估计肾小球滤过率（eGFR）与因疲劳住院发生率之间的关联。
基于人群的回顾性队列研究，使用省级行政数据集。
加拿大艾伯塔省。
2009年1月1日至2016年12月31日期间在艾伯塔省至少进行过1次门诊血清肌酐测量的18岁以上人群。
首次门诊血清肌酐用于估算肾小球滤过率。使用国际疾病分类第十版（ICD - 10）编码R53.x确定因疲劳住院情况。
根据患者的初始eGFR将其按CKD类别分层。我们使用负二项回归来确定肾功能下降（参考eGFR≥60 mL/min/1.73m²）是否会导致因疲劳住院的发生率增加。估计值按年龄分层，并对年龄、性别、社会经济地位和合并症进行了调整。
研究队列包括2823270名成年人，平均年龄46.1岁，中位随访时间6.0年；在14703914人年的随访期间，发生了5422例因疲劳住院事件。在所有年龄层中，因疲劳住院的调整率均随肾功能下降而增加。透析患者中的发生率最高（与eGFR≥60 mL/min/1.73m²相比，18至64岁、65至74岁和75岁及以上人群的调整发病比率分别为24.47、6.66和3.13）。
疲劳住院编码未经验证；参考组限于至少进行过1次门诊血清肌酐测量的成年人；仍存在残余混杂的可能性。
肾功能下降与因疲劳住院的发生率增加相关。有必要进一步研究解决CKD人群疲劳问题的方法。
不适用（非临床试验）。
