Effect of clinical factors on trajectory of functional performance in patients undergoing hemodialysis.

Publisher: Informa Healthcare Country of Publication: England NLM ID: 8701128 Publication Model: Print Cited Medium: Internet ISSN: 1525-6049 (Electronic) Linking ISSN: 0886022X NLM ISO Abbreviation: Ren Fail Subsets: MEDLINE

Publication: London : Informa Healthcare
Original Publication: New York, N.Y. : M. Dekker, c1987-

Karnofsky Performance Status* ; Renal Dialysis*; Aged ; Female ; Humans ; Kidney Failure, Chronic/therapy ; Logistic Models ; Longitudinal Studies ; Male ; Middle Aged ; Multivariate Analysis ; Retrospective Studies ; Risk Factors ; Taiwan

Purpose: This study aimed to investigate the association between clinical factors and temporary changes in functional performance in patients undergoing hemodialysis.
Methods: This was a retrospective, longitudinal observational study conducted from 2015 to 2017. Eight-two patients undergoing hemodialysis in the outpatient clinic were enrolled. Functional performance was measured using the Karnofsky Performance Status (KPS) scale. Collected data for analysis included demographics, laboratory parameters, and KPS scale scores. All participants were grouped into a high KPS cluster and a low KPS cluster based on dynamic changes in KPS scales from 2015 to 2017.
Results: Participants in the high KPS cluster demonstrated an approximate trend, and those in the low KPS cluster demonstrated a low pattern. By stepwise selection model analysis, age (OR 1.12, 95% CI 1.03-1.23, p  = 0.011), serum BUN (OR 1.08, 95% CI 1.02-1.16, p  = 0.015), calcium levels (OR 3.24, 95% CI 1.2-8.73, p  = 0.02), and beta-2-microglobulin (OR > 1.0, CI >1.00-<1.01, p  = 0.031) showed risk for the low KPS cluster. Male sex (OR 0.20, 95% CI 0.04-0.96, p  = 0.045) and albumin level (OR 0.02, 95% CI 0-0.4, p  = 0.009) showed a low risk for the low KPS cluster.
Conclusions: A different trajectory pattern was observed between the high and low KPS clusters in a 3-year period. Risk factors for the low KPS cluster were age, serum BUN, calcium, and beta-2-microglobulin levels. Male sex and serum albumin levels reduced the risk for the low KPS cluster.

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Keywords: Age; Karnofsky scale; albumin; hemodialysis

Date Created: 20201222 Date Completed: 20210830 Latest Revision: 20210830

20240829

PMC7758042

10.1080/0886022X.2020.1852090

33349082