運動與老年慢性腎臟病患者的相關性研究

Association between exercise and renal function in elderly people with chronic kidney disease

蔡詩梅(Shr-Mei Tsai)

指導教授 ： 廖勇柏

中山醫學大學/健康管理學院/公共衛生學系碩士班/碩士(2017年)

摘要

前言：健康行為可以減緩慢性腎臟病的惡化，如何尋找最具成本效益且可以容易進行，運動似乎是融入人們日常生活的好方法。
目的：本研究探討老年人口運動習慣對於腎功能變化的相關性。
方法：採回溯性世代研究，分析成人健康檢查資料，利用多變項線性迴歸分析，以兩次腎絲球過濾率差(ΔeGFR)為依變項，三組運動型態為自變項，並同時調整年齡、性別、身體質量指數、健康行為(包括抽煙、喝酒、嚼檳榔)、第一次腎絲球過濾率、尿蛋白、疾病嚴重度等干擾因子。
結果：本研究對象共222,053人 運動對eGFR小於60 ml/min/1.73m2的族群，有運動對ΔeGFR會上升，達到劑量效應關係(P <0.05)，具有顯著關係。依不同性別而言，女性腎功能較差的患者有運動能顯著改善腎功能，但男性患者則無明顯差異。
結論：對於老年慢性腎臟病患者，運動可延緩腎功能惡化。

關鍵字

運動 ； 慢性腎臟病 ； 老年人

並列摘要

Background: Healthy behavior can slow down the progression and deterioration of chronic kidney disease. Exercise seems to be an excellent and cost-effective way to be integrated in people’s daily life.
Objective: This study explored and analyzed the association between exercise habits and renal function, specifically among elderly people over 65 years old with chronic kidney disease who underwent adult health examination.
Material and methods: This is a retrospective cohort study and we use the adult health examination results as the basis of this study. By using the multiple linear regression analysis, the change of ΔeGFR was the dependent variable, and different levels of exercise were the independent variables. In this study, we adjusted the age, sex, body mass index, health behavior (including smoking, drinking, and chewing betel nut), the eGFR at baseline, urinary protein, Charlson comorbidity index, and other confounding factors.
Result: A total of 222,053 people were included in this study. Among the patients with eGFR less than 60 ml/min/1.73m2, exercise was proven to have significant effect on the improved renal function, and it yielded dose-dependent effect (P <0.05). When we compared between male and female, elderly women with eGFR <60 ml/min/1.73m2 had significant improved kidney function after they implemented exercise in their daily lives. However, there was no statistically significant result among male elderlies with eGFR <60 ml/min/1.73m2.
Conclusion: For elderly patients with chronic kidney disease, exercise can delay the progression and deterioration of kidney function.

並列關鍵字

Exercise ； Chronic kidney disease ； Elderly

參考文獻

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