Wirkner Janine, Scheuch Matthias, Dabers Thomas, Freiin von Rheinbaben Sabrina, Fiene Beate, Aymanns Simone, Endlich Karlhans, Endlich Nicole, Lendeckel Uwe, Rettig Rainer, Grabe Hans Jörgen, Stracke Sylvia
Clinical Psychology, Institute for Psychology, University of Greifswald, 17489 Greifswald, Germany.
Department of Internal Medicine A, Nephrology, University Medicine Greifswald, 17475 Greifswald, Germany.
J Clin Med. 2022 Aug 10;11(16):4671. doi: 10.3390/jcm11164671.
Given the increasing prevalence of chronic kidney disease (CKD) and its impact on health care, it is important to better understand the multiple factors influencing health-related quality of life (HRQOL), particularly since they have been shown to affect CKD outcomes. Determinants of HRQOL as measured by the validated Kidney Disease Quality of Life questionnaire (KDQOL) and the Patient Health Questionnaire depression screener (PHQ-9) were assessed in a routine CKD patient sample, the Greifswald Approach to Individualized Medicine (GANI_MED) renal cohort (N = 160), including a wide range of self-reported data, sociodemographic and laboratory measures. Compared to the general population, CKD patients had lower HRQOL indices. Dialysis was associated with (1) low levels of physical functioning, (2) increased impairments by symptoms and problems, and (3) more effects and burden of kidney disease. HRQOL is seriously affected in CKD patients. However, impairments were found irrespective of eGFR decline and albuminuria. Rather, the comorbid conditions of depression and diabetes predicted a lower HRQOL (physical component score). Further studies should address whether recognizing and treating depression may not only improve HRQOL but also promote survival and lower hospitalization rates of CKD patients.
鉴于慢性肾脏病(CKD)的患病率不断上升及其对医疗保健的影响,更好地了解影响健康相关生活质量(HRQOL)的多种因素非常重要,特别是因为这些因素已被证明会影响CKD的预后。在一个常规的CKD患者样本——格赖夫斯瓦尔德个性化医疗方法(GANI_MED)肾脏队列(N = 160)中,评估了通过经过验证的肾脏病生活质量问卷(KDQOL)和患者健康问卷抑郁筛查量表(PHQ - 9)所测量的HRQOL的决定因素,其中包括广泛的自我报告数据、社会人口统计学和实验室测量指标。与普通人群相比,CKD患者的HRQOL指数较低。透析与以下情况相关:(1)身体功能水平低下,(2)症状和问题导致的损害增加,以及(3)肾脏疾病的更多影响和负担。CKD患者的HRQOL受到严重影响。然而,无论估算肾小球滤过率(eGFR)下降和蛋白尿情况如何,均发现存在损害。相反,抑郁症和糖尿病的合并症预示着较低的HRQOL(身体成分得分)。进一步的研究应探讨识别和治疗抑郁症是否不仅可以改善HRQOL,还能提高CKD患者的生存率并降低住院率。