Quality of life and kidney function in CKD patients: a longitudinal study.

IF 3.9 2区医学 Q1 UROLOGY & NEPHROLOGY

Clinical Kidney Journal Pub Date : 2025-03-24 eCollection Date: 2025-04-01 DOI:10.1093/ckj/sfae429

Graziella D'Arrigo, Carmela Marino, Patrizia Pizzini, Graziella Caridi, Francesco Marino, Giovanna Parlongo, Annalisa Pitino, Mercedes Gori, Giovanni Tripepi, Francesca Mallamaci, Carmine Zoccali

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引用次数: 0

Abstract

Background: In chronic kidney disease (CKD), a declining glomerular filtration rate (GFR) leads to physiological and psychosocial burdens that impair quality of life (QoL). However, this relationship has been mainly investigated in cross-sectional studies and a limited number of longitudinal studies that reported contrasting results.

Objective and methods: This longitudinal study included 582 patients with Stages 2-5 CKD. QoL was assessed using the Kidney Disease Quality of Life (KDQOL™) instrument at baseline and annually for 3 years. GFR was estimated using the MDRD equation, the equation recommended by guidelines that were contemporary to the study cohort. We analysed the relationship between repeated measures of QoL and GFR using unadjusted and adjusted mixed linear models (MLMs).

Results: The cohort had a mean age of 61 ± 12 years, with 60% males and 33% diabetics. Baseline eGFR was 36±13 ml/min/1.73 m². Physical and mental component summary scores of QoL were 43.5 and 45.1, respectively. In MLM analyses adjusted for potential confounders, a 10 ml/min/1.73 m² decrease in eGFR was significantly associated with reductions in physical (β = -0.60, P = .016) and mental (β = -0.52, P = .045) component summary scores over the follow-up period. The physical functioning and role limitation physical health subcomponents of QoL were primarily responsible for these associations.

Conclusions: This longitudinal study shows that declining kidney function is associated with deteriorating QoL in CKD patients independently of other factors. These findings support the current KDIGO recommendation that regular monitoring of QoL should be incorporated into clinical practice to improve patient outcomes.

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CKD患者的生活质量和肾功能：一项纵向研究。

背景：在慢性肾脏疾病（CKD）中，肾小球滤过率（GFR）下降会导致生理和社会心理负担，从而影响生活质量（QoL）。然而，这种关系主要是在横断面研究和有限数量的纵向研究中调查的，这些研究报告了相反的结果。目的和方法：本纵向研究纳入582例2-5期CKD患者。使用肾脏疾病生活质量（KDQOL™）仪器在基线和每年评估生活质量，为期3年。GFR使用MDRD方程估计，该方程是研究队列的当代指南所推荐的。我们使用未调整和调整的混合线性模型（MLMs）分析了重复测量的QoL和GFR之间的关系。结果：该队列的平均年龄为61±12岁，男性占60%，糖尿病患者占33%。基线eGFR为36±13 ml/min/1.73 m²。生活质量的生理和心理成分综合得分分别为43.5分和45.1分。在针对潜在混杂因素进行调整的MLM分析中，在随访期间，eGFR下降10 ml/min/1.73 m²与身体（β = -0.60, P = 0.016）和精神（β = -0.52, P = 0.045）成分总结得分的降低显著相关。生活质量的身体功能和角色限制是造成这些关联的主要原因。结论：这项纵向研究表明，CKD患者肾功能下降与生活质量恶化相关，独立于其他因素。这些发现支持目前KDIGO的建议，即应将生活质量的定期监测纳入临床实践，以改善患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Kidney Journal Medicine-Transplantation

CiteScore

6.70

自引率

10.90%

发文量

242

审稿时长

8 weeks

期刊介绍： About the Journal Clinical Kidney Journal: Clinical and Translational Nephrology (ckj), an official journal of the ERA-EDTA (European Renal Association-European Dialysis and Transplant Association), is a fully open access, online only journal publishing bimonthly. The journal is an essential educational and training resource integrating clinical, translational and educational research into clinical practice. ckj aims to contribute to a translational research culture among nephrologists and kidney pathologists that helps close the gap between basic researchers and practicing clinicians and promote sorely needed innovation in the Nephrology field. All research articles in this journal have undergone peer review.