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慢性肾脏病患者与非慢性肾脏病患者下肢肌肉力量和功能与肾阻力指数的关联

Association of Lower Extremity Muscle Strength and Function with Renal Resistive Index in Individuals with and without Chronic Kidney Disease.

作者信息

Nishitani Natsumi, Kosaki Keisei, Mori Shoya, Matsui Masahiro, Sugaya Takeshi, Kuro-O Makoto, Saito Chie, Yamagata Kunihiro, Maeda Seiji

机构信息

Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki 305-8577, Japan.

Institute of Health and Sport Sciences, University of Tsukuba, Ibaraki 305-8577, Japan.

出版信息

Geriatrics (Basel). 2023 Dec 3;8(6):118. doi: 10.3390/geriatrics8060118.

Abstract

Age-related loss of lower extremity muscle strength is pronounced in individuals with chronic kidney disease (CKD). In contrast, an increase in intrarenal flow pulsatility results in initial age-related changes in renal hemodynamics, leading to the development of CKD. To date, it remains unclear whether lower extremity muscle strength determines elevated renal flow pulsatility. This study aimed to determine the association of lower extremity muscle strength and function with intrarenal hemodynamics in individuals with and without CKD. One hundred seventy-six individuals without CKD (aged 63 ± 9 years) and 101 individuals with CKD (aged 66 ± 8 years) were included in this study. Using Doppler ultrasound, the renal resistive index (RI) was measured as a parameter of renal hemodynamics. Knee extensor muscle strength (KES), gait speed (GS), and the 30 s chair stand test (30s-CST) were used to measure lower extremity muscle strength and function. Multivariate analyses showed that GS and 30s-CST scores were independent determinants of renal RI, whereas the KES score was not associated with renal RI in individuals with and without CKD. In the two-way analysis of covariance, renal RI was the highest in individuals with CKD who had lower KES, GS, and 30s-CST scores. Reduced lower extremity muscle strength and function are independent determinants of elevated renal flow pulsatility in individuals with and without CKD.

摘要

慢性肾脏病(CKD)患者中,与年龄相关的下肢肌肉力量丧失十分明显。相反,肾内血流搏动性增加会导致肾脏血流动力学出现与年龄相关的初始变化,进而引发CKD。迄今为止,尚不清楚下肢肌肉力量是否决定了肾血流搏动性的升高。本研究旨在确定有或无CKD的个体中,下肢肌肉力量和功能与肾内血流动力学之间的关联。本研究纳入了176名无CKD的个体(年龄63±9岁)和101名有CKD的个体(年龄66±8岁)。使用多普勒超声测量肾阻力指数(RI)作为肾血流动力学的参数。采用膝关节伸肌力量(KES)、步速(GS)和30秒坐立试验(30s-CST)来测量下肢肌肉力量和功能。多变量分析显示,在有或无CKD的个体中,GS和30s-CST评分是肾RI的独立决定因素,而KES评分与肾RI无关。在双向协方差分析中,KES、GS和30s-CST评分较低的CKD个体的肾RI最高。无论有无CKD,下肢肌肉力量和功能下降都是肾血流搏动性升高的独立决定因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c35/10742463/670c90fae4a8/geriatrics-08-00118-g001.jpg

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