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免疫球蛋白A肾病对美国患者及其护理伙伴的人文负担。

The humanistic burden of immunoglobulin A nephropathy on patients and care-partners in the United States.

作者信息

Szklarzewicz Justyna, Floege Ute, Gallego Daniel, Gibson Keisha, Kalantar-Zadeh Kamyar, Helm Kelly, Robinson Dale, Schneider Bonnie, Smith Philip, Tullus Kjell, Poyan-Mehr Ali, Hendry Bruce, Balkaran Bridget L, Jauregui Adam K, Wang Aolin, Nason Ian, Hazra Nisha C, Xu Chunyi, Liu Jingyi, Zhou Zheng-Yi, Bensink Mark

机构信息

University Hospitals of Leicester NHS Trust, Leicester, UK.

University Hospital of the RWTH Aachen University, Aachen, Germany.

出版信息

Qual Life Res. 2025 Feb;34(2):353-363. doi: 10.1007/s11136-024-03813-x. Epub 2024 Oct 26.

Abstract

PURPOSE

This cross-sectional survey study quantified the humanistic burden of immunoglobulin A nephropathy (IgAN), in terms of physical and mental health-related quality of life (HRQoL) and work productivity, among adults with primary IgAN and their care-partners.

METHODS

HRQoL was assessed (01/31/22 - 05/31/23) with validated tools including the KDQoL-36 (with SF-12), GAD-7 (anxiety), PHQ-9 (depression), and WPAI: SHP (work productivity). Participant characteristics and total/domain scores were summarized; selected outcomes were compared to an external, kidney disease-free cohort.

RESULTS

117 adults with IgAN and their care-partner pairs, and one adult without a care-partner, were included. The mean ages of patients and care-partners were 38.0 (SD: 8.6) and 40.2 (11.8) years, respectively; 55.9% and 43.6% were female. Mean physical and mental SF-12 scores for patients were 46.7 (SD: 8.0) and 41.9 (9.2), respectively, and 50.7 (7.3) and 43.7 (10.24) for care-partners. Both SF-12 components for patients, and the mental component for care-givers, were significantly worse compared to the US general population. Among patients, 27.1% had moderate/severe anxiety and 49.2% reported at least moderate depression. Compared to external controls, patients experienced significantly higher severity of anxiety (6.6 vs. 5.4) and depression (8.1 vs. 6.6; both p < 0.0001). Among care-partners, 13.7% experienced moderate anxiety and 37.8% experienced moderate/moderately-severe depression. Among employed individuals, both groups reported IgAN-related absenteeism (8.8-9.4%), presenteeism (25.1-25.9%), and overall work impairment (30.4-30.5%).

CONCLUSION

US adults with IgAN and their care partners experience impairments to mental and physical HRQoL and heightened levels of depression and anxiety, underscoring the need for effective IgAN therapies and care-partner support.

摘要

目的

这项横断面调查研究量化了原发性免疫球蛋白A肾病(IgAN)成年患者及其护理伙伴在身心健康相关生活质量(HRQoL)和工作生产力方面的人文负担。

方法

采用KDQoL-36(含SF-12)、GAD-7(焦虑)、PHQ-9(抑郁)和WPAI:SHP(工作生产力)等经过验证的工具评估HRQoL(2022年1月31日至2023年5月31日)。总结参与者特征及总分/领域得分;将选定结果与外部无肾病队列进行比较。

结果

纳入了117名患有IgAN的成年患者及其护理伙伴对,以及1名无护理伙伴的成年患者。患者和护理伙伴的平均年龄分别为38.0岁(标准差:8.6)和40.2岁(11.8);女性分别占55.9%和43.6%。患者的SF-12身体和心理平均得分分别为46.7(标准差:8.0)和41.9(9.2),护理伙伴的得分分别为50.7(7.3)和43.7(10.24)。与美国普通人群相比,患者的SF-12两个维度得分以及护理者的心理维度得分均显著更差。在患者中,27.1%有中度/重度焦虑,49.2%报告至少有中度抑郁。与外部对照组相比,患者的焦虑严重程度(6.6对5.4)和抑郁严重程度(8.1对6.6;均p<0.0001)显著更高。在护理伙伴中,13.7%有中度焦虑,37.8%有中度/中度重度抑郁。在就业个体中,两组均报告有与IgAN相关的旷工(8.8 - 9.4%)、出勤主义(25.1 - 25.9%)和总体工作受损(30.4 - 30.5%)。

结论

美国患有IgAN的成年患者及其护理伙伴在身心健康相关生活质量方面存在损害,抑郁和焦虑水平升高,这凸显了有效治疗IgAN及为护理伙伴提供支持的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d491/11865151/529d7044d13d/11136_2024_3813_Fig1_HTML.jpg

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