血液透析病患家屬罹患慢性腎臟病盛行率及相關因子研究

The Prevalence and Associated Factors of Chronic Kidney Disease among Relatives of Hemodialysis Patients

吳繼澄(Ji-Cheng Wu) ； 俞靜儀(Ching-I Yu) ； 廖瑛君(Ying-Chun Liao) ； 李文欽(Wen-Chin Lee) ； 林耀信(Yau-Hsing Lin) ； 李建德(Chien-Te Lee)

《臺灣腎臟護理學會雜誌》 12卷3期 (2013/09) Pp. 34-48

摘要

研究報告顯示血液透析家屬發生慢性腎臟病（chronic kidney disease, CKD）有較高的風險，探討本土性CKD的發生因子是目前台灣防治CKD積極推動的政策。本文以血液透析病患之家屬（二等親屬及配偶）為研究對象，收集其尿液、血液生化檢測、生活型態（抽菸、喝酒、嚼檳榔、睡眠時間長短及運動頻率）等資料，分析發生因子與罹患CKD之相關性。收案血液透析病患家屬257位，包括二等親家屬161人，配偶96人，以病患家屬之人口學、疾病史、家族史、用藥史及生活型態為變項，分析可能罹患CKD之盛行率與相關因子，結果顯示：（1）血液透析病患家屬可能發生CKD盛行率約14％；（2）由卡方檢定得知病患家屬關係、年齡、教育程度、有痛風之疾病史、長期使用痛風及保健用藥與有無罹患CKD達顯著意義；（3）以邏輯斯迴歸分析預測CKD之共同重要解釋變項有性別、抽菸、喝酒及有心臟血管疾病之家族史。研究結論：本研究發現透析病患的家屬和配偶有較高的CKD盛行率，其相關因子有病患之配偶、年齡老化、低教育程度、有痛風之疾病及用藥、心臟血管疾病之家族史、有抽菸及喝酒之生活習慣者，故建議透析病患的家屬應更留意本身對疾病的認知及正確生活型態，降低CKD的發生率。

關鍵字

血液透析 ； 慢性腎臟病 ； 盛行率 ； 危險因子

並列摘要

Relatives and spouses of chronic hemodialysis patients have been found to have a high risk of chronic kidney disease (CKD). The identification of localized risk factors in this population is an important part of the CKD prevention policy in Taiwan. Our study aimed to investigate prevalence and risk factors of CKD in the relatives and spouses in hemodialysis patients. A total of 257 family members were recruited, including 161 first- and second- degree relatives and 96 spouses. Information was collected through urine samples, biochemical blood tests and lifestyle (smoking, alcohol consumption, betel nut use, sleeping habits and exercise frequency) for analysis. Patient families' demographics, disease history, family history, medication history and lifestyle were set as the variables for the analysis of prevalence and related factors with potential CKD patients. Our results found that (1) potential prevalence rate of CKD in relatives and spouses was 14%. (2) Chi-Square analysis revealed that relationship to the patient, age, education, history of gout, long-term use of uric acid lowering agents and health supplements (OR: 2.28) had a significant influence on CKD incidence. (3) Logistic regression analysis found the predictive variables for CKD prevalence were gender, smoking, alcohol consumption and family history of cardiovascular disease. Our study demonstrated that the factors associated with the prevalence of CKD were being the patient's spouse, older age, low level of education, history gout and use of gout medication, family history of cardiovascular disease in the family, smoking and alcohol consumption. The family members of dialysis patients should therefore pay more attention to their understanding of the disease and proper lifestyle in order to reduce the prevalence of CKD.

並列關鍵字

hemodialysis ； chronic kidney disease ； prevalence ； risk factor