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功能和身体表现下降:病中的大脑 (BRINK) 队列研究
Allyson Hart1,2,3, Kayla Horak2, Nicholas S Roetker2
1Nephrology Division, Department of Medicine, Hennepin Healthcare, Minneapolis, MN, USA.
Kidney medicine
|February 6, 2024
概括
随着慢性病 (CKD) 阶段和白尿,身体表现下降. 短物理性能电池 (SPPB) 评分下降在透析开始后稳定,但步行速度继续下降.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 老年病的医生 老年病的医生
- 物理医学 物理医学
背景情况:
- 患有功能衰竭的患者表现出体力表现的下降,但这种下降在病期间的进展,包括过渡到透析,仍然不清楚.
- 了解慢性病 (CKD) 的身体功能轨迹对于患者管理和干预策略至关重要.
研究的目的:
- 为了研究估计的膜过率 (eGFR) 和尿中的白蛋白与肌素比率 (UACR) 与随时间变化的体力表现之间的关联.
- 为了检查身体功能的轨迹,包括短物理性能电池 (SPPB) 和步行速度,在成年人患有CKD,特别是在透析的开始.
主要方法:
- 一项观察性队列研究,对562名社区成年人进行观察,年龄≥45岁,来自脑病 (BRINK) 队列.
- 线性混合效应回归模型被用来分析与eGFR和UACR相关的SPPB和步行速度的变化,平均随访时间为63个月.
- 调整为共变量的模型被用来考虑潜在的混因素.
主要成果:
- 较低的eGFR与SPPB得分的较大下降之间观察到一个分级的关联,在更晚期CKD阶段的个体中,下降幅度更大.
- 较高的UACR与SPPB分数和步行速度的较大下降显著相关,独立于eGFR.
- 虽然在调整后的模型中,透析开始后SPPB得分的下降没有加速,但透析后的步行速度继续下降.
结论:
- 慢性病阶段和白蛋白尿与身体表现的逐渐下降有关.
- 通过SPPB测量体力表现,在透析开始后似乎稳定下来,而步行速度继续下降,这表明病进展和透析对不同身体功能措施的明显影响.
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