老年慢性肾脏病患者生活质量评估及其危险因素分析

目的:了解65岁以上慢性肾脏病（chronic kidney disease，CKD）患者的老年综合评估评分情况，并分析患者生活质量的相关影响因素。方法:本研究为回顾性队列研究，入选2016年10月至2019年10月在山西省人民医院肾内科诊断为CKD且65岁以上的189例患者，依据患者是否透析分为透析组（ ...

Assessment and risk factors analysis for quality of life in elderly patients with chronic kidney disease

Objective To understand the comprehensive geriatric assessment (CGA) scores in chronic kidney disease (CKD) patients aged 65 years and older, and analyze the related influencing factors of quality of life. Methods A total of 189 patients who were over 65 years old and diagnosed with CKD in the Department of Nephrology of Shanxi Provincial People's Hospital from October 2016 to October 2019 were included retrospectively. The patients were divided into dialysis group (n=90 cases) and non-dialysis group (n=99 cases) according to whether dialysis or not. The concise CGA scores included age, basic activities of daily living (BADL), instrumental activities of daily living (IADL), and modified cumulative illness rating score for geriatrics (MCIRS-G). Pearson correlation analysis was used to analyze the relationship between different scale scores and clinical indexes. Multiple linear regression analysis was used to further analyze independent related factors of the quality of life in elderly CKD patients. Results Compared with the non-dialysis group, the BADL score and IADL score in the dialysis group were significantly reduced (70.00±33.28) vs (93.38±14.32), t=6.166, P＜0.001；(9.78±7.12) vs (15.95±5.74), t=6.520, P＜0.001], while the MCIRS-G score was significantly increased (31.13±4.00) vs (27.29±5.17), t=-5.741, P＜0.001]. Linear regression analysis performed on the data of non-dialysis group patients showed that estimated glomerular filtration rate (eGFR), serum uric acid (SUA), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), blood potassium and chlorine were positively correlated with BADL and IADL scores (all P＜0.05). B-type natriuretic peptide (BNP) was negatively correlated with BADL score (P＜0.01). BNP and age were negatively correlated with IADL score (both P＜0.05). Fasting blood glucose (FBG) was positively correlated with MCIRS-G or MCIRS-G other than kidney (both P＜0.05), and eGFR, SUA, total cholesterol, and HDL-C were negatively correlated with MCIRS-G or MCIRS-G other than kidney (all P＜0.05). Multiple linear regression analysis showed that eGFR was an independent influencing factor for BADL (P＜0.01). Age and eGFR were independent influencing factors for IADL (both P＜0.05). Conclusions The decline of quality of life in elderly CKD patients is related with eGFR, SUA, age, BNP and HDL-C levels, and eGFR and age are independent influencing factors.