糖尿病肾病患者的生活质量:来自韩国慢性肾脏病患者预后队列研究(KNOW-CKD)队列的研究结果

Quality of life in patients with diabetic nephropathy: findings from the KNOW-CKD (Korean Cohort Study for Outcomes in Patients with Chronic Kidney Disease) cohort.

作者信息

Kim Hyunsuk, Lee Joongyub, Choi Gwang Ho, Jeong Hae Min, Kim Seok Hyung, Gu Jae Eon, Yoo Jeong-Ju, Han Miyeun, Kim Hyo-Jin, Sung Su-Ah, Han Seung Hyeok, Kim Yeong Hoon, Yoon Jong-Woo, Heo Jongho, Oh Kook-Hwan

机构信息

Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Republic of Korea.

Prevention and Management Center, Inha University Hospital, Incheon, Republic of Korea.

出版信息

Kidney Res Clin Pract. 2022 Jan;41(1):43-57. doi: 10.23876/j.krcp.21.068. Epub 2021 Nov 8.

Abstract

BACKGROUND

Diabetic nephropathy (DN) can affect quality of life (QoL) because it requires arduous lifelong management. This study analyzed QoL differences between DN patients and patients with other chronic kidney diseases (CKDs).

METHODS

The analysis included subjects (n = 1,766) from the KNOW-CKD (Korean Cohort Study for Outcomes in Patients with Chronic Kidney Disease) cohort who completed the Kidney Disease Quality of Life Short Form questionnaire. After implementing propensity score matching (PSM) using factors that affect the QoL of DN patients, QoL differences between DN and non-DN participants were examined.

RESULTS

Among all DN patients (n = 390), higher QoL scores were found for taller subjects, and lower scores were found for those who were unemployed or unmarried, received Medical Aid, had lower economic status, had higher platelet counts or alkaline phosphatase levels, or used clopidogrel or insulin. After PSM, the 239 matched DN subjects reported significantly lower patient satisfaction (59.9 vs. 64.5, p = 0.02) and general health (35.3 vs. 39.1, p = 0.04) than the 239 non-DN subjects. Scores decreased in both groups during the 5-year follow-up, and the scores in the work status, sexual function, and role-physical domains were lower among DN patients than non-DN patients, though those differences were not statistically significant.

CONCLUSION

Socioeconomic factors of DN were strong risk factors for impaired QoL, as were high platelet, alkaline phosphatase, and clopidogrel and insulin use. Clinicians should keep in mind that the QoL of DN patients might decrease in some domains compared with non-DN CKDs.

摘要

背景

糖尿病肾病(DN)会影响生活质量(QoL),因为它需要终身进行艰苦的管理。本研究分析了DN患者与其他慢性肾脏病(CKD)患者之间的生活质量差异。

方法

分析纳入了来自韩国慢性肾脏病患者预后队列研究(KNOW-CKD)队列的1766名受试者,这些受试者完成了肾脏病生活质量简表问卷。在使用影响DN患者生活质量的因素进行倾向得分匹配(PSM)后,研究了DN参与者与非DN参与者之间的生活质量差异。

结果

在所有390名DN患者中,身高较高的患者生活质量得分较高,而失业或未婚、接受医疗救助、经济状况较差、血小板计数或碱性磷酸酶水平较高、使用氯吡格雷或胰岛素的患者得分较低。倾向得分匹配后,239名匹配的DN受试者报告的患者满意度(59.9对64.5,p = 0.02)和总体健康状况(35.3对39.1,p = 0.04)显著低于239名非DN受试者。在5年随访期间,两组得分均下降,DN患者在工作状态、性功能和角色-身体领域的得分低于非DN患者,尽管这些差异无统计学意义。

结论

DN的社会经济因素是生活质量受损的强危险因素,高血小板、碱性磷酸酶、氯吡格雷和胰岛素的使用也是如此。临床医生应牢记,与非DN的CKD患者相比,DN患者在某些领域的生活质量可能会下降。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b017/8816412/746befe01af8/j-krcp-21-068f1.jpg

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