title: Impaired Kidney Function and Associated Factors Among Rural Adults With Disabilities in Taiwan.
abstract: BACKGROUND
  The results of numerous studies indicate that people with disabilities seek more healthcare than those who are not disabled, particularly for conditions such as chronic kidney disease, cardiovascular disease, and obesity. However, little is known about the incidence of impaired kidney function and its associated factors among adults with disabilities in Taiwan.
  
  
  OBJECTIVE
  The aim of this study was to explore the prevalence and factors associated with impaired kidney function among adults with disabilities.
  
  
  METHODS
  This descriptive study was nurse led and was conducted as part of a health promotion program for disadvantaged rural adults with disabilities in Chiayi County, Taiwan. Health screening and a health needs survey were conducted between July and December 2013. Kidney function, physiological biomarkers, health-related behaviors, and demographic characteristics were examined.
  
  
  RESULTS
  Eight hundred ten rural adults with disabilities were enrolled. The most common disabilities included physical-related disability (33.1%), intellectual-related disability (26.7%), and hearing and vision impairment (18.6%). The prevalence of impaired kidney function in this population was 85%. According to classification for chronic kidney disease, 68.6% were in Stages 1-2, and 16.8% were in Stages 3-4. Univariate analysis showed that impaired kidney function was significantly associated with lower educational level (p < .001), hearing or vision impairment (p < .001), being overweight or obese (p < .05), high systolic blood pressure (p < .01), fasting blood glucose (p < .001), total cholesterol (p < .001), total triglyceride (p < .05), older age (p < .001), smoking (p < .05), chewing betel nuts (p = .001), and low levels of participation in social activities (p < .05). The final logistic regression model showed that residents with disabilities who were older or had less education, high fasting blood glucose, and high total cholesterol tended to have impaired kidney function after adjustment for other potential confounding variables.
  
  
  CONCLUSIONS
  Most participants showed impaired kidney function. The factors that were found to relate significantly to this impairment include being overweight, having hyperlipidemia, having hypertension, having high fasting blood glucose, and having an unhealthy lifestyle. Because of the lack of symptoms during the early stages of chronic kidney disease, a community-based health promotion program for these factors is an important element in health advocacy for this vulnerable population.
authors.affiliation: 1MS, Adjunct Instructor, Department of Nursing, Chang Gung University of Science and Technology 2MD, Attending Physician, Internal Medicine, Chang Gung Memorial Hospital 3MSN, Director, Department of Health Promotion, Chiayi Bureau of Health 4PhD, RN, Associate Professor, Department of Nursing, Chang Gung University of Science and Technology 5MSN, RN, Case Manager, Department of Chronic Kidney Disease, Tzu-Chi Hospital 6PhD, RN, Professor, College of Nursing, Chang Gung University of Science and Technology Chiayi, Professor (Joint Appointment), Department of Nursing, Chang Gung University, Taoyuan, and Research Fellow (Joint Appointment), Department of Cardiology, Chang Gung Memorial Hospital, Chiayi.
authors.forename: Chu-Yeh
authors.initials: CY
authors.lastname: Chen
authors.forename: Wen-Nan
authors.initials: WN
authors.lastname: Chiu
authors.forename: Yu-Chen
authors.initials: YC
authors.lastname: Lin
authors.forename: Sui-Hwi
authors.initials: SH
authors.lastname: Jane
authors.forename: Hsin-Hung
authors.initials: HH
authors.lastname: Chiang
authors.forename: Mei-Yen
authors.initials: MY
authors.lastname: Chen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D013624:Taiwan / Q000453:epidemiology