Silva Maryanne Zilli Canedo, Antonio Karina Jesus, Reis João Marcos Soares, Alves Leticia Salmazzo, Caramori Jacqueline Costa Teixeira, Vogt Barbara Perez
Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, Brazil.
Nutrition Course, Health Sciences School, University of Western São Paulo (UNOESTE), Presidente Prudente, Brazil.
Kidney Res Clin Pract. 2021 Jun;40(2):294-303. doi: 10.23876/j.krcp.20.159. Epub 2021 May 27.
Due to the poor outcomes associated with the impairment of physical function and muscle strength in patients on maintenance dialysis, it is important to understand the factors that may influence physical function and muscle strength. The aim of this study was to explore the factors associated with physical function in hemodialysis and peritoneal dialysis patients.
Patients with chronic kidney disease on dialysis for at least 3 months, aged 18 years old or above, were enrolled. Physical function was assessed by handgrip strength, gait and sit-to-stand tests, and the Short Physical Performance Battery (SPPB). Clinical and laboratory data were collected to verify the association with physical function parameters through binary logistic regression.
One-hundred ninety patients on maintenance dialysis were included; 140 patients (73.7%) on hemodialysis and 50 (26.3%) on peritoneal dialysis. The mean age was 57.3 ± 14.9 years, 109 (57.4%) were male, and 87 (45.8%) were older than 60 years. The median SPPB was 8.0 points (6.0-10.0 points) and the mean ± standard deviation of handgrip strength was 24.7 ± 12.2 kg. Binary logistic regression showed that age, type of renal replacement therapy, diabetes mellitus, and serum creatinine were significantly associated with both higher 4-meter gait test times and lower SPPB scores. Only age and diabetes mellitus were associated with higher sit-to-stand test times, while age and ferritin were associated with lower handgrip strength.
Age, diabetes mellitus, serum creatinine, and hemodialysis modality are factors related to physical function in dialysis patients.
由于维持性透析患者的身体功能和肌肉力量受损会导致不良后果，因此了解可能影响身体功能和肌肉力量的因素非常重要。本研究的目的是探讨血液透析和腹膜透析患者身体功能的相关因素。
纳入年龄在18岁及以上、慢性肾脏病透析至少3个月的患者。通过握力、步态和坐立试验以及简短体能状况量表（SPPB）评估身体功能。收集临床和实验室数据，通过二元逻辑回归验证与身体功能参数的相关性。
共纳入190例维持性透析患者；其中140例（73.7%）接受血液透析，50例（26.3%）接受腹膜透析。平均年龄为57.3±14.9岁，109例（57.4%）为男性，87例（45.8%）年龄大于60岁。SPPB中位数为8.0分（6.0 - 10.0分），握力的平均值±标准差为24.7±12.2 kg。二元逻辑回归显示，年龄、肾脏替代治疗类型、糖尿病和血清肌酐与4米步态试验时间延长和SPPB评分降低均显著相关。只有年龄和糖尿病与坐立试验时间延长有关，而年龄和铁蛋白与握力降低有关。
年龄、糖尿病、血清肌酐和血液透析方式是与透析患者身体功能相关的因素。
