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全身炎症与老年慢性肾脏病住院患者功能恢复降低有关。

Systemic inflammation is associated with reduced functional recovery in older inpatients with chronic kidney disease.

作者信息

Ohashi Keita, Iwata Kentaro, Yamada Kanji, Yoshimura Yoshihiro, Nozaki Atsuki, Yamamoto Akio, Ono Kumiko, Kitai Takeshi, Yoshimoto Akihiro, Kohara Nobuo, Ishikawa Akira

机构信息

Department of Rehabilitation, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.

Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan.

出版信息

Int Urol Nephrol. 2025 Aug 21. doi: 10.1007/s11255-025-04721-w.

Abstract

PURPOSE

To investigate the association between systemic inflammation and activities of daily living (ADL) in older patients with chronic kidney disease (CKD) in the acute phase.

METHODS

This observational, retrospective cohort study included patients with CKD aged 65 years and older with unscheduled admissions to the nephrology department between January 2019 and February 2022. Patients who underwent maintenance hemodialysis therapy; died during hospitalization; were treated in other departments; experienced serious events during hospitalization; or did not receive rehabilitation during hospitalization were excluded. Systemic inflammation was assessed by the modified Glasgow Prognostic Score (mGPS) on admission, and ADL was assessed by functional independence measure (FIM) at discharge.

RESULTS

A total of 89 patients (median age, 80 years [interquartile range, 75-84 years]) were included in the analysis. An mGPS score of 0, 1, and 2 was assigned to 41 (46.1%), 15 (16.9%), and 33 (37.1%) patients, respectively. In multivariable analysis, the mGPS (SE = 2.16; β =  - 0.25; P = 0.001) was significantly associated with the FIM score at discharge. On the other hand, albumin (ρ = 0.093; 95% CI, - 0.12 to 0.30; P = 0.384) and CRP level (ρ =  - 0.176; 95% CI; - 0.37 to 0.03; P = 0.098) were not significantly correlated with the FIM score at discharge.

CONCLUSION

Among older patients with CKD in the acute phase, systemic inflammation assessed using the mGPS may be useful for predicting ADL.

摘要

目的

探讨老年慢性肾脏病(CKD)急性期患者全身炎症与日常生活活动能力(ADL)之间的关联。

方法

这项观察性、回顾性队列研究纳入了2019年1月至2022年2月期间因计划外入院至肾内科的65岁及以上CKD患者。排除接受维持性血液透析治疗的患者;住院期间死亡的患者;在其他科室接受治疗的患者;住院期间发生严重事件的患者;或住院期间未接受康复治疗的患者。入院时采用改良格拉斯哥预后评分(mGPS)评估全身炎症,出院时采用功能独立性测量(FIM)评估ADL。

结果

共有89例患者(中位年龄80岁[四分位间距,75 - 84岁])纳入分析。mGPS评分为0、1和2的患者分别有41例(46.1%)、15例(16.9%)和33例(37.)。在多变量分析中,mGPS(标准误=2.16;β=-0.25;P=0.001)与出院时的FIM评分显著相关。另一方面,白蛋白(ρ=0.093;95%可信区间,-0.12至0.30;P=0.384)和CRP水平(ρ=-0.176;95%可信区间;-0.37至0.03;P=0.098)与出院时的FIM评分无显著相关性。

结论

在老年CKD急性期患者中,使用mGPS评估的全身炎症可能有助于预测ADL。

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