肾功能与健康相关生命质量：一项全国健康访谈与体检调查结果。
Health-Related Quality of Life according to Renal Function: Results from a Nationwide Health Interview and Examination Survey.
机构信息
Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.
Department of Medicine, Rotes Kreuz Krankenhaus, Bremen, Germany.
出版信息
Kidney Blood Press Res. 2022;47(1):13-22. doi: 10.1159/000518668. Epub 2021 Nov 22.
BACKGROUND
Most studies on health-related quality of life (HRQoL) in chronic kidney disease (CKD) focus on patients with end-stage kidney disease although they represent a small proportion of patients with CKD. We aimed to analyze HRQoL according to glomerular filtration rate (GFR) categories in a population-based sample of adults living in Germany.
METHODS
Data from the German health interview and examination survey conducted from 2008 to 2011 were used. Participants with valid interview and examination data aged 40-79 years were included (n = 5,159). Serum creatinine levels were used to calculate estimated GFR via the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. We classified kidney function in GFR categories according to the Kidney Disease Improving Global Outcomes Initiative (KDIGO) guidelines on CKD: G1 (high): ≥90 mL/min/1.73 m2, G2 (normal): 60-89 mL/min/1.73 m2, G3a (mildly decreased): 45-59 mL/min/1.73 m2, G3b (moderately decreased): 30-44 mL/min/1.73 m2, G4/5 (severely decreased/end-stage kidney disease): <30 mL/min/1.73 m2. HRQoL was evaluated with the Short Form Health Survey (SF-36). Different multivariate linear and logistic regression models were used to analyze the association of HRQoL with GFR categories.
RESULTS
Overall, 5.9% had a GFR <60 mL/min/1.73 m2 (corresponding to categories G3a, G3b, and G4/5). Compared to category G2 linear regression showed a decline in physical HRQoL in categories G3a (-2.34, p = 0.004), G3b (-5.37, p = 0.009), and G4/5 (-4.82, p = 0.117). No decline in mental HRQoL was detected with increasing GFR categories. Categories G3a to G4/5 were significantly associated with a low perceived general state of health (G3a: odds ratio [OR] = 2.03, p = 0.001; G3b: OR = 3.01, p = 0.009; G4/5: OR = 8.70, p = 0.016) when compared to category G2.
CONCLUSION
In a representative sample of adults living in Germany, both physical HRQoL and the perceived general state of health are already significantly reduced in category G3a.
背景
大多数关于慢性肾脏病（CKD）患者健康相关生活质量（HRQoL）的研究都集中在终末期肾病患者身上，尽管他们只占 CKD 患者的一小部分。我们旨在分析德国成年人中基于人群的样本中根据肾小球滤过率（GFR）类别进行的 HRQoL。
方法
使用了 2008 年至 2011 年进行的德国健康访谈和检查调查的数据。纳入了具有有效访谈和检查数据且年龄在 40-79 岁的参与者（n=5159）。使用血清肌酐水平通过慢性肾脏病流行病学合作组（CKD-EPI）方程计算估计的 GFR。我们根据肾脏病改善全球结果倡议（KDIGO）关于 CKD 的指南将肾功能分类为 GFR 类别：G1（高）：≥90 mL/min/1.73 m2，G2（正常）：60-89 mL/min/1.73 m2，G3a（轻度降低）：45-59 mL/min/1.73 m2，G3b（中度降低）：30-44 mL/min/1.73 m2，G4/5（严重降低/终末期肾病）：<30 mL/min/1.73 m2。使用简短健康调查（SF-36）评估 HRQoL。使用不同的多变量线性和逻辑回归模型分析 HRQoL 与 GFR 类别的关联。
结果
总体而言，5.9%的人肾小球滤过率<60 mL/min/1.73 m2（对应于 G3a、G3b 和 G4/5 类别）。与类别 G2 相比，线性回归显示 G3a（-2.34，p=0.004）、G3b（-5.37，p=0.009）和 G4/5（-4.82，p=0.117）类别的身体 HRQoL 下降。随着 GFR 类别的增加，没有检测到心理 HRQoL 的下降。与类别 G2 相比，类别 G3a 至 G4/5 与较低的感知一般健康状况显著相关（G3a：优势比[OR]=2.03，p=0.001；G3b：OR=3.01，p=0.009；G4/5：OR=8.70，p=0.016）。
结论
在德国成年人的代表性样本中，G3a 类别的身体 HRQoL 和感知的一般健康状况已经显著降低。
Zotero 插件