정상 신기능의 성인과 신기능 저하 환자에서의 삶의 질 비교: 2012년 국민건강영양조사

Abstract

Background : There were a few articles that health-related quality of life (HRQoL) was lower in advanced chronic kidney disease (CKD) and end-stage renal disease. The aim of this study was to figure out the association between HRQoL and the indicators of CKD including increased albuminuria in a representative sample of Korean adults. Methods: Using data of KNHANES 2012, we analyzed the relationship between CKD and HRQoL determined by the EuroQol 5 Dimensions (EQ-5D)-3 levels in adults (age ≥ 19). CKD was defined as: low estimated glomerular filtration rate (eGFR < 60 mL/min/1.73 m2); elevated urinary albumin to creatinine ratio (ACR ≥ 30 mg/g); or either CKD indicator. The individual weighted samples were used and complex sampling design of the survey was considered to obtain the variances. General linear analyses were used to comparing the mean EQ-5D index and EQ-visual analogue scale (VAS) score in non-CKD and CKD. Logistic regression analyses were applied to examine the relationships between the lowest quartile of EQ-5D index with CKD and its indicators (GFR, ACR). Multivariate odds ratios were calculated after adjusting for demographic factors (age group, gender, BMI), socioeconomic factors (marital status, income, occupation, education, residence), health related behaviors (smoking, physical activity) and comorbidities (hypertension, diabetes, stroke, ischemic heart disease, depression). Results: Total 4980 samples were enrolled, and the prevalence of CKD was 8.4%. The mean EQ-5D index and EQ-VAS was lower in CKD (EQ-5D 0.90±0.008, EQ-5D VAS 69.49±1.04) than non-CKD (EQ-5D 0.95±0.002, EQ-5D VAS 74.77±0.35).(p<0.0001) The results are presented in tabular form. Conclusion: Early-stage CKD was associated with lower HRQoL. However, the low eGFR was stronger indicator of HRQoL than albuminuria.