Yuav ua li cas cov tsos mob hloov dua 5 xyoos nyob rau hauv Non-dialysis Dependent CKD Cov neeg mob
Dec 30, 2022
Tam sim no, tsis muaj kev nkag siab txog kev hloov pauv ntawm cov tsos mob hauv cov neeg mob CKD ntawm ntau theem. Muaj ob peb txoj kev tshawb fawb ntev los tshawb xyuas qhov kev hloov pauv ntawm cov tsos mob hauv cov neeg mob uas tsis yog kev lim ntshav-dependent CKD, thiab cov txiaj ntsig ntawm cov kev tshawb fawb uas twb muaj lawm tsis sib haum. Txog rau qhov kawg no, raws li Fabkis CKD-lub raum kab mob sib kis thiab cov ntaub ntawv xov xwm network (CKD-REIN) cov ntaub ntawv tshawb fawb, cov kws tshawb fawb txawv teb chaws tau ua txoj kev tshawb fawb yav tom ntej los txiav txim siab txog 5- xyoo cov tsos mob thiab cov yam ntxwv ntawm cov neeg mob CKD. Txoj kev tshawb no tau pom tias cov neeg mob uas muaj cov tsos mob hnyav dua (31 feem pua) muaj cov tsos mob hnyav zuj zus nyob rau lub sijhawm, thiab cov neeg mob no muaj feem cuam tshuam rau kev loj hlob ntawm CKD thiab kev ua neej tsis zoo. Cov neeg mob uas muaj cov tsos mob me me ntawm lub hauv paus (69 feem pua) muaj cov tsos mob zoo tag nrho.
Nyem rau cistanche phelypaea rau mob raum
Txoj kev tshawb fawb CKD-REIN yog qhov kev tshawb fawb yav tom ntej ntawm cov neeg laus CKD nrog eGFR<60 ml/min/1.73 m2 not receiving renal replacement therapy (KRT). Baseline data such as sociodemographic data, body mass index, smoking history, medication history, medical history, and laboratory indicators of CKD patients who participated in the CKD-REIN study between July 2013 and May 2016 were collected. During the study period, patients' symptoms were assessed annually using the Kidney Disease Quality of Life-36 (KDQOL-36) scale until December 2020. The KDQOL-36 scale is divided into 5 parts, including physical health score, mental health score, the kidney disease burden of kidney disease, kidney disease symptoms/problems, and kidney disease impact. The primary endpoint of this study was the score of the Kidney Disease Symptoms/Problems subscale of the KDQOL-36 scale, including muscle aches, chest pains, cramps, itchy skin, dry skin, shortness of breath, dizziness, loss of appetite, fatigue, numbness in hands and feet, 11 symptoms, including nausea or upset stomach, were scored, with lower scores indicating more severe symptoms. The score data of baseline and follow-up 1, 2, 3, and 5 years were recorded, and at least one data was collected for each patient. A Latent Class Mixed Effects Model (JLCMM) was used to identify types of symptom score trajectories.
Kev tshwm sim
Tag nrho ntawm 2787 tus neeg mob tau suav nrog hauv txoj kev tshawb fawb, lub hnub nyoog nruab nrab (± tus qauv sib txawv [SD]) yog 67 ± 13 xyoo, thiab 66 feem pua yog txiv neej. Qhov nruab nrab eGFR yog 33 ± 13 ml / min / 1.73 m2, thiab 45 feem pua ntawm cov neeg mob nyob hauv CKD theem 4-5. Qhov qhab nia nruab nrab yog 75 ± 16 ntsiab lus. Qhov tshwm sim ntawm cov tsos mob muaj xws li los ntawm 24 feem pua (mob hauv siab) mus rau 83 feem pua (qee zaum), qaug zog (83 feem pua), mob leeg (82 feem pua), cramps (72 feem pua), tawv nqaij qhuav (60 feem pua), thiab ua tsis taus pa. (68 feem pua) yog cov feem ntau. 98 feem pua ntawm cov neeg mob tau tshaj tawm tsawg kawg ib qho tsos mob.
During a median follow-up (interquartile range) of 5.3 years (3.4-6.0), 690 patients initiated KRT and 490 died before KRT. The JLCMM analysis identified 2 types of symptom trajectories (Fig. 1), with 31% (n = 875) of patients having "lower symptom scores and worsening trajectories," characterized by more severe symptoms at baseline and, over time, worsening symptom scores. A decrease of >10 cov ntsiab lus qhia tias cov tsos mob hnyav zuj zus tuaj; 69 feem pua (n=1912) ntawm cov neeg mob muaj "cov tsos mob ntau dua thiab cov kab mob sib kis tau zoo", uas yog tus cwj pwm los ntawm cov tsos mob me me ntawm lub hauv paus thiab tag nrho cov tsos mob ruaj khov nyob rau lub sijhawm. Raws li qhov xav tau, cov neeg mob uas "cov qhab nia qis dua thiab cov kab mob hnyav dua" muaj qhov pheej hmoo siab dua ntawm KRT thiab kev tuag ua ntej KRT.
Tus neeg mob yam ntxwv los ntawm txawv cov tsos mob trajectories
Cov neeg mob uas muaj cov tsos mob qis dua thiab cov kab mob hnyav dua feem ntau muaj ntshav qab zib (48 feem pua vs. 40 feem pua), rog rog (36 feem pua vs. 33 feem pua), comorbidities (diabetes, kab mob plawv), anemia (55 feem pua vs. 29 feem pua), thiab hypocalcemia (4 feem pua vs. 1 feem pua); thiab kev ua kom lub cev tsawg dua (57 feem pua vs. 44 feem pua ) thiab kev siv tshuaj ntau dua (9 ± 4 vs. . 7 ± 4), qis kwv yees glomerular filtration rate (eGFR) (26 ± 10 vs. 37 ± 11 ml / min), kev ua neej tsis zoo thiab cov tsos mob hnyav dua. Tib lub sijhawm, qhov poob qis ntawm eGFR kuj tseem nrawm dua (3.56, 95 feem pua kev ntseeg siab lub sijhawm [CI] 3.80-3.33 vs. 1.15, 95 feem pua CI 21.24-21.06) ml / min / 1.73 m2 / xyoo.
Xaus thiab Kev Sib Tham
Txoj kev tshawb no yog tsom los txheeb xyuas qhov 5- xyoo trajectory thiab cov yam ntxwv ntawm cov tsos mob hauv cov neeg mob CKD. Cov txiaj ntsig tau pom tias cov neeg mob uas muaj cov tsos mob hnyav dua (31 feem pua) muaj cov tsos mob hnyav zuj zus, thiab pom tias cov neeg mob no muaj feem cuam tshuam rau kev loj hlob ntawm CKD. Qhov zoo dua. Cov neeg mob uas muaj cov tsos mob me me ntawm lub hauv paus (69 feem pua) muaj cov tsos mob zoo tag nrho.
Hauv kev saib xyuas cov neeg mob uas muaj kab mob ntev, tus neeg mob lub neej zoo thiab cov tsos mob hnyav tau txais kev saib xyuas ntxiv. Nyob rau hauv Lub Raum Kab Mob Standardized Outcomes Initiative, cov neeg mob hemodialysis tau txheeb xyuas qhov qaug zog yog ib qho tseem ceeb cuam tshuam rau lawv tus mob. Nyob rau hauv tus txheej txheem ntawm kev loj hlob ntawm tus kab mob, cov neeg mob uas muaj cov kab mob ntev yuav muaj kev poob hauj lwm sai thiab ua rau lub nra hnyav. Kev nkag siab txog kev hloov pauv ntawm cov neeg mob cov xwm txheej yog qhov tseem ceeb heev rau kev tsim cov tswv yim kho mob.
Tsis tas li ntawd, ntxiv rau kev saib xyuas cov tsos mob thiab kev kuaj ntsuas, cov kws tshawb fawb tseem qhia tias KDQOL-36 nplai lossis lwm daim ntawv nug uas siv tau yuav tsum tau siv los ntsuas cov neeg mob cov tsos mob. Cov txiaj ntsig yuav pab cov kws kho mob nkag siab txog tus neeg mob qhov kev hloov pauv ntau dua, ua tiav kev kho mob thaum ntxov, thiab txhim kho tus neeg mob cov txiaj ntsig kev kho mob.
Yog xav paub ntxiv: Ali.ma@wecistanche.com
