Aging of Renal Function Estimation in Elderly Community Dwellers Experiences in Taiwanese Population

台灣社區老人腎功能老化之推估

李世代(Shyh-Dye Lee) ； 莊榮彬(Rong-Bin Chuang) ； 黎家銘(Chia-Ming Li) ； 潘文涵(Wen-Han Pan)

《台灣老年醫學雜誌》 1卷3期 (2006/02) Pp. 159-173

https://doi.org/10.29462/TGG.200602.0003

摘要

目的：老化涵蓋了多方面之自然過程，幾乎包含所有的器官組織，而腎臟常被視為全面老化過程之重要部份。我們期盼透過簡易之實用操作來推估社區老人腎功能的老化趨勢。
方法：研究數據來自1999到2000年所進行之台灣老人營養與健康調查研究(NAHSIT)，從全國一般社區之老人分層抽樣2,064個65歲以上之老人樣本（男性1,047、女性1,017），其中排除罹患可能含影響腎功能病變之情況後，共獲有508個樣本（男性265；女性243）。透過Cockcroft and Gault公式作肌酸酐廓清率之推估(eC(下標 Cr))，並進行趨勢檢測、Logrank試驗與回歸分析來推斷不同年齡層老人的腎功能遞變趨勢。
結果：經研究推算全部老人男性樣本在65-69歲、70-74歲、75-79歲及80歲以上各個年齡層eC(下標 Cr)之分佈分別為65.5±15、57.0±15、51.0±12 及39.6±15毫升／分；在排除可能含影響腎功能病變情況後，其eC(下標 Cr)之年齡層分佈則分別為63.0±15、58.5±13、52.2±12及39.8±10毫升／分；而全部老人女性樣本各個年齡層eC(下標 Cr)分佈分別為61.6±14、54.1±25、45.3±14及37.3±10毫升／分，在排除可能含影響腎功能病變情況後之分佈則為59.1±12、52.8±13、47.5±18及35.5±11毫升／分。雖然從本研究之eC(下標 Cr)未達統計意義之呈現，然其大致隨年齡之增加而呈一定程度之衰退；且由一般樣本及排除可能影響腎功能病變樣本之兩種推估模式所得結果間，並未有明顯的差異，而部份體質人類學及健康行為因素或可能扮演重要的角色。
結論：本研究可提供探討常態腎功能老化的實證基礎及在社區老人中可能之推估模式，其結果可做為老人腎功能之「準」常模，亦可作為相關臨床、研究、公共衛生、衛生教育重要之指標。當然，結果仍非完美，進一步確實而精準的縱向式研究推估仍有其必要。

關鍵字

老化 ； 腎功能 ； 肌酸酐廓清率C(下標 Cr) ； 台灣老人營養與健康調查研究NAHSIT

並列摘要

Objectives: Aging is a natural process involving many aspects and including virtually every organ and tissue. Kidney is usually regarded as an important part during the overall process of aging. We aimed at investigating the aging trend of renal function in elderly community dwellers in Taiwan through a practical approach of renal function estimation.
Methods: Data were derived from the latest Nutrition and Health Survey in Taiwan (NAHSIT) for the elderly, conducted from 1999 to 2000 with a complex sampling scheme to obtain representative samples from general communities in Taiwan. Ultimately, after the exclusion of those with morbid conditions likely to influence renal function, 508 target samples (265 males and 243 females) had been recruited from a total of 2,064 subjects aged 65 years and over (1,047 males and 1,017 females) as the target sample subjects. Practical approach of the transition of renal function estimation (eC(subscript Cr)) was carried out by using Cockcroft and Gault formula from serum creatinine level, age and body weight. And the results had been examined with Trend test, Logrank test, and necessary regression analyses.
Results: The results showed that eC(subscript Cr) for the total samples read 65.5±15, 57.0±15, 51.0±12 & 39.6±15 ml/min respectively in the age strata of 65-69, 70-74, 75-79 and 80+ in male, and 63.0±15, 58.5±13, 52.2±12 & 39.8±10 ml/min respectively in each age strata of the healthier male subjects recruited. eC(subscript Cr), on the other hand, emerged as 61.6±14, 54.1±25, 45.3±14 & 37.3±10 ml/min and 59.1±12, 52.8±13, 47.5±18 & 35.5±11 ml/min respectively in the female counterparts. There showed a trend of transitional decay of renal function by age in the total sample group and in the healthier recruited sample group; the trend, however, was not significant statistically. Moreover, there was no significant difference between total-sample approach and the healthier-sample approach. Some anthropometric factors and health-related behaviors might play their roles.
Conclusions: This study offered some evidence-based outcomes for probing into the natural decay of kidney function, and even the quasi-or semi-norm renal function in the elderly, which can be regarded as an important indicator of clinical, research, public health, health education and even policy making in Taiwan. Certainly, for a more valid and precise estimation, further advanced longitudinal study design is still necessary.

並列關鍵字

aging ； renal function ； C(subscript Cr) ； NAHSIT ； Taiwan