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儿童期起病的终末期肾病青少年及青年的抑郁与健康相关生活质量:日本的一项多中心研究

Depression and health-related quality of life in adolescents and young adults with childhood-onset end-stage kidney disease: a multicenter study in Japan.

作者信息

Miura Kenichiro, Hattori Motoshi, Iwano Masayuki, Inoue Eisuke, Gotoh Yoshimitsu, Okamoto Takayuki, Nishiyama Kei, Hirano Daishi, Nishimura Katsuji, Narita Ichiei

机构信息

Department of Pediatric Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666, Japan.

Department of Nephrology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-Cho, Yoshida-Gun, Fukui, 910-1193, Japan.

出版信息

Clin Exp Nephrol. 2023 May;27(5):473-479. doi: 10.1007/s10157-023-02330-4. Epub 2023 Feb 25.

Abstract

BACKGROUND

Patient survival and physical outcomes among children with end-stage kidney disease (ESKD) have significantly improved, and recent research has focused on long-term depression symptoms and health-related quality of life (HRQOL). However, no studies have been conducted among adolescents and young adults with childhood-onset ESKD in Japan.

METHODS

This multicenter study included 45 adolescents and young adults aged 16-39 years who developed ESKD at age < 20 years. Depression symptoms were measured using the Beck Depression Inventory (BDI)-II. The Short Form-36 Health Survey (SF-36) was used to assess HRQOL. Factors associated with depression and HRQOL were analyzed.

RESULTS

Depression (BDI-II score ≥ 14) was observed in 13 (29%) patients. Patient's SF-36 physical component summary (PCS) and mental component summary (MCS) scores were comparable with those for the general population. Lower estimated glomerular filtration rate, higher BDI-II scores, and lower body mass index were associated with lower PCS scores. BDI-II scores were negatively correlated with MCS scores. We observed a trend that unemployment was associated with lower MCS scores.

CONCLUSIONS

Depression is frequently observed among adolescents and young adults with childhood-onset ESKD. Regular screening for psychosocial concerns, maintaining stable graft functions, and achieving optimal nutritional status may contribute to improved well-being among these patients.

摘要

背景

终末期肾病(ESKD)患儿的患者生存率和身体状况有了显著改善,近期研究聚焦于长期抑郁症状和健康相关生活质量(HRQOL)。然而,日本尚未针对儿童期发病的ESKD青少年及青年成人开展相关研究。

方法

这项多中心研究纳入了45名年龄在16 - 39岁之间、20岁之前发病的ESKD青少年及青年成人。使用贝克抑郁量表(BDI)-II测量抑郁症状。采用简明健康调查量表(SF-36)评估HRQOL。分析与抑郁和HRQOL相关的因素。

结果

13名(29%)患者存在抑郁(BDI-II评分≥14)。患者的SF-36身体成分汇总(PCS)和心理成分汇总(MCS)得分与普通人群相当。较低的估计肾小球滤过率、较高的BDI-II评分和较低的体重指数与较低的PCS得分相关。BDI-II评分与MCS得分呈负相关。我们观察到失业与较低的MCS得分相关的趋势。

结论

儿童期发病的ESKD青少年及青年成人中经常观察到抑郁。定期筛查心理社会问题、维持稳定的移植肾功能以及实现最佳营养状况可能有助于改善这些患者的幸福感。

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