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COVID-19 パンデミックによるヘルスケア障害と慢性腎臓病の進行
Richard Liu1, Rahul Abraham2, Sarah E Conderino1
1Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA.
Journal of general internal medicine
|September 4, 2025
まとめ
COVID-19 パンデミックは慢性腎臓疾患 (CKD) の治療を妨害し,2020年に医療訪問を減らし,腎臓機能の低下を加速しました. パンデミック後のケア改善により,この減少が遅れたのかもしれません.
科学分野:
- 腎臓科
- 公衆衛生
- 流行病学
背景:
- COVID-19 パンデミックは,世界的な医療システムを大幅に混乱させました.
- 慢性腎臓病 (CKD) の患者は独特の課題と治療の障害に直面しました.
- 慢性腎臓病の進行に対するパンデミックの影響を理解することは,将来の医療計画にとって極めて重要です.
研究 の 目的:
- 慢性腎臓病患者のヘルスケアを求める行動に対するCOVID-19のパンデミックの影響を評価する.
- 慢性腎臓病の進行に対する パンデミック関連の介護障害の影響を評価する.
- ニューヨーク市における腎臓機能の低下とヘルスケア訪問の傾向を分析する.
主な方法:
- 電子医療記録を使用した84, 062人のCKD患者 (≥50歳) の遡及コホート研究 (2017~2022年).
- 介護の障害は,腎臓病:グローバルアウトカム改善 (KDIGO) のガイドラインで推奨されるより少ない訪問として定義されています.
- 推定グルメルフィルタレーション率 (eGFR) の変化と訪問傾向を分析するために,線形混合効果モデルを使用した.
主要な成果:
- 医療訪問は2020年に急激に減少し,2022年までに完全には回復していない.
- 2020年には10.6%の顕著なeGFR減少がみられ,その後は減速した.
- 過去に不十分な治療を受けた患者は,パンデミック期間中に診察の頻度が増加し,他の患者は推奨値を維持した.
結論:
- COVID-19 パンデミックはCKDの治療を妨害し,2020年に医療へのアクセスが減り,腎臓機能の低下が加速しました.
- 2020年以降の腎臓機能低下の改善は,医療利用の強化と新しい治療法に関連している可能性があります.
- 研究結果は,公衆衛生上の危機に際して慢性腎臓病患者の脆弱性と,回復力のある医療戦略の必要性を強調しています.
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