Global Payer Evidence, AstraZeneca, Gaithersburg, MD, USA.
Adelphi Real World, Bollington, UK.
Int J Clin Pract. 2021 Aug;75(8):e14326. doi: 10.1111/ijcp.14326. Epub 2021 May 17.
Chronic kidney disease patients have impaired health-related quality of life and an increased risk of hyperkalaemia.
The objective was to evaluate the impact of hyperkalaemia on health-related quality of life, and investigate lifestyle change recommendations, in these patients.
The Adelphi Real World Chronic Kidney Disease Specific Programme™ was used. Data were collected from physicians and patients with non-dialysis dependent stage 3a, 3b and 4 chronic kidney disease from the US, France, Germany, Spain, Italy, the UK and China. Patients completed the Kidney Disease Quality of Life Instrument and EuroQol-5D-3L. Analyses compared data between hyperkalaemic (serum potassium >5.0 mmol/L) and normokalaemic (serum potassium 3.5-5.0 mmol/L) patients.
Overall, 1149 patients were included (hyperkalaemic: n = 216, normokalaemic: n = 933; US: n = 376, Europe: n = 490, China: n = 283). Hyperkalaemic vs normokalaemic patients experienced more symptoms (P < .001) and had numerically lower scores, indicating poorer health-related quality of life, in all Kidney Disease Quality of Life domains, with significant differences for three/five domains. Hyperkalaemic patients reported numerically lower EuroQol-5D-3L utility index and visual analogue scores, indicating poorer health status, than normokalaemic patients. A higher proportion of hyperkalaemic than normokalaemic patients were recommended to reduce dietary potassium (P < .05). More normokalaemic than hyperkalaemic patients reported making a radical change in five/six recommended lifestyle changes, with the difference significant for four/six recommendations.
Hyperkalaemia is associated with an incremental impairment of the health-related quality of life in chronic kidney disease patients. A better understanding of the impact of hyperkalaemia in these patients could improve patient outcomes.
慢性肾脏病患者的健康相关生活质量受损，且发生高钾血症的风险增加。
旨在评估高钾血症对这些患者健康相关生活质量的影响，并调查生活方式改变建议。
使用 Adelphi 真实世界慢性肾脏病特定项目。数据来自美国、法国、德国、西班牙、意大利、英国和中国的非透析依赖的 3a、3b 和 4 期慢性肾脏病医生和患者。患者完成肾脏病生活质量量表和 EuroQol-5D-3L。分析比较了高钾血症（血清钾＞5.0mmol/L）和血钾正常（血清钾 3.5-5.0mmol/L）患者的数据。
共纳入 1149 例患者（高钾血症：n=216，血钾正常：n=933；美国：n=376，欧洲：n=490，中国：n=283）。高钾血症患者经历了更多的症状（P＜0.001），且所有肾脏病生活质量量表领域的评分均较低，表明健康相关生活质量较差，其中三个/五个领域的差异具有统计学意义。高钾血症患者报告的 EuroQol-5D-3L 效用指数和视觉模拟评分数值较低，表明健康状况较差，高于血钾正常患者。与血钾正常患者相比，建议更多的高钾血症患者减少饮食中的钾（P＜0.05）。与高钾血症患者相比，更多的血钾正常患者报告在五项/六项推荐的生活方式改变中做出了重大改变，其中四项/六项建议的差异具有统计学意义。
高钾血症与慢性肾脏病患者健康相关生活质量的逐渐下降有关。更好地了解高钾血症对这些患者的影响可能会改善患者的结局。
