Egawa Masahiro, Yoshimura Ryuichi, Matsui Kosuke, Yoshikane Kaori, Ito Takafumi
Division of Nephrology, Izumo Medical Life Cooperative Izumo-Shimin Hospital, Izumo, Japan.
Division of Nephrology, Department of Internal Medicine, Teikyo University Chiba Medical Center, 3426-3, Anesaki, Ichihara, Chiba, 299-0111, Japan.
Int Urol Nephrol. 2025 Sep 1. doi: 10.1007/s11255-025-04764-z.
With an aging global population, the prevalence of chronic kidney disease (CKD) has increased. Dysphagia is a major challenge in this population. However, little information is available regarding the association between dysphagia and the prevalence of CKD. We aimed to evaluate whether a severity-dependent association exists between dysphagia and CKD.
This retrospective cross-sectional study included 520 patients, aged ≥ 65 years, who had been admitted to Izumo Medical Life Cooperative Izumo-shimin Hospital from April 2022 to May 2023. Dysphagia was assessed using a modified water swallowing test with a rating scale of 1-5. A score of 1-3 represented dysphagia. CKD was defined as an estimated glomerular filtration rate ≤ 60 mL/min/1.73 m. An association between dysphagia and the prevalence of CKD was assessed using logistic regression models adjusting for clinically relevant factors.
CKD was observed in 19 (38.0%), 246 (57.9%), and 28 (62.2%) patients with normal deglutition, nearly normal deglutition, and dysphagia, respectively. Multivariable-adjusted models showed that dysphagia was associated with the prevalence of CKD (adjusted odds ratios of patients with dysphagia vs. those with normal deglutition: 2.51 (95% confidence interval, 1.01-6.20) Additionally, a severity-dependent association between dysphagia and the prevalence of CKD was observed [1.00 (reference), 1.76 (0.92-3.36), 2.43 (0.96-6.16), and 3.24 (0.42-25.0) in patients with no, almost no, mild, and moderate-to-severe dysphagia, respectively; p for trend = 0.044].
Dysphagia was associated with the prevalence of CKD in a severity-dependent manner.
随着全球人口老龄化，慢性肾脏病（CKD）的患病率有所上升。吞咽困难是这一人群面临的一项重大挑战。然而，关于吞咽困难与CKD患病率之间的关联，目前可用信息较少。我们旨在评估吞咽困难与CKD之间是否存在严重程度依赖性关联。
这项回顾性横断面研究纳入了2022年4月至2023年5月期间入住出云医疗生活协同组合出云市民医院的520例年龄≥65岁的患者。吞咽困难采用改良水吞咽试验进行评估，评分范围为1至5分。1至3分表示吞咽困难。CKD定义为估算肾小球滤过率≤60 mL/min/1.73 m²。采用多因素逻辑回归模型评估吞咽困难与CKD患病率之间的关联，并对临床相关因素进行校正。
吞咽功能正常、吞咽功能近乎正常和吞咽困难的患者中，分别有19例（38.0%）、246例（57.9%）和28例（62.2%）被观察到患有CKD。多变量校正模型显示，吞咽困难与CKD患病率相关（吞咽困难患者与吞咽功能正常患者的校正比值比：2.51（95%置信区间，1.01至6.20））。此外，还观察到吞咽困难与CKD患病率之间存在严重程度依赖性关联[无吞咽困难、几乎无吞咽困难、轻度吞咽困难和中重度吞咽困难的患者分别为1.00（参照）、1.76（0.92至3.36）、2.43（0.96至6.16）和3.24（0.42至25.0）；趋势p值 = 0.044]。
吞咽困难与CKD患病率之间存在严重程度依赖性关联。
