Department of Health Care Policy and Health Economics, Institute of Medicine, University of Tsukuba, Ibaraki, Japan; Department of Clinical Laboratory Medicine, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Department of Nephrology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Department of Health Care Policy and Health Economics, Institute of Medicine, University of Tsukuba, Ibaraki, Japan.
J Ren Nutr. 2024 Mar;34(2):161-169. doi: 10.1053/j.jrn.2023.10.001. Epub 2023 Oct 11.
The Chronic Kidney Disease (CKD) practice facilitation program in the Frontier of Renal Outcome Modifications in Japan study reduced cardiovascular disease (CVD) events in patients with CKD. 10-year long-term survivors with CKD lived with serious complications, including end-stage kidney disease and CVD. This study aimed to measure health-related quality of life in 10-year long-term CKD survivors and examine the predictors and determinants of clinical indices for measured quality of life (QOL) scores.
The EQ-5D-5L, a generic preference-based instrument, was administered to 1,473 CKD survivors enrolled in the Frontier of Renal Outcome Modifications in JapanFrontier of Renal Outcome Modifications in JapanFrontier of Renal Outcome Modifications in Japan study. The 10th-year data collection was performed by either primary care physicians or participants who filled out questionnaires from October 2018 to March 31, 2019.
The response rate was 38.2% (423/1,473). The mean QOL score was 0.893 (95% confidence interval (CI), 0.880-0.906), and the median QOL score was 1.000 (interquartile range (IQR), 0.826-1.000). The mean QOL score in participants with renal replacement therapy was 0.824 (95% CI, 0.767-0.881), and the median was 0.828 (IQR, 0.755-1.000). The mean QOL score in participants with CVD was 0.877 (95% CI, 0.811-0.943), and the median was 1.000 (IQR, 0.723-1.000). The mean QOL score in participants with 50% decline in estimated glomerular filtration was 0.893 (95% CI, 0.860-0.926), and the median was 0.889 (IQR, 0.825-1.000). The decrease in QOL scores with baseline CKD stages was significant according to the Jonckheere-Terpstra test for trend (P = .002). Baseline age, systolic blood pressure, and history of hyperuricemia were significant predictors of 10th-year QOL scores.
We suggest that CKD complications negatively affect the QOL scores in 10-year long-term survivors with CKD. CKD guideline-based practices, prevention of end-stage kidney disease/CVD and management of hypertension, diabetes and hyperuricemia, might contribute to future health-related quality of life in patients with CKD.
日本肾脏预后修正前沿研究中的慢性肾脏病（CKD）实践促进计划降低了 CKD 患者的心血管疾病（CVD）事件。患有 CKD 的 10 年长期幸存者患有严重的并发症，包括终末期肾病和 CVD。本研究旨在测量 10 年 CKD 幸存者的健康相关生活质量，并检查临床指标对测量生活质量（QOL）评分的预测因子和决定因素。
采用 EQ-5D-5L 量表对参加日本肾脏预后修正前沿研究的 1473 名 CKD 幸存者进行了调查。第 10 年的数据收集由初级保健医生或参与者通过填写 2018 年 10 月至 2019 年 3 月 31 日的问卷完成。
应答率为 38.2%（423/1473）。QOL 评分的平均值为 0.893（95%置信区间（CI），0.880-0.906），中位数为 1.000（四分位距（IQR），0.826-1.000）。接受肾脏替代治疗的参与者的 QOL 评分平均值为 0.824（95%CI，0.767-0.881），中位数为 0.828（IQR，0.755-1.000）。患有 CVD 的参与者的 QOL 评分平均值为 0.877（95%CI，0.811-0.943），中位数为 1.000（IQR，0.723-1.000）。肾小球滤过率下降 50%的参与者的 QOL 评分平均值为 0.893（95%CI，0.860-0.926），中位数为 0.889（IQR，0.825-1.000）。根据 Jonckheere-Terpstra 趋势检验，基线 CKD 分期与 QOL 评分的下降呈显著相关（P=0.002）。基线年龄、收缩压和高尿酸血症史是第 10 年 QOL 评分的显著预测因子。
我们认为 CKD 并发症会对患有 CKD 的 10 年长期幸存者的 QOL 评分产生负面影响。基于 CKD 指南的实践、预防终末期肾病/ CVD 和管理高血压、糖尿病和高尿酸血症，可能有助于改善患者未来的健康相关生活质量。
