目的：台灣社會人口結構改變，高齡社會伴隨慢性疾病盛行率高，其中慢性腎臟病（Chronic Kidney Disease，簡稱 CKD）人口持續地增加，隨著疾病變化，身體功能持續衰退，造成疾病和身體功能惡性循環，甚至影響生活品質，本研究目的為探討腎臟病3b-5期病患生活品質與功能性體適能的相關與差異，進一步探討影響病患身心健康之因子。
方法：於腎臟科門診徵求60歲以上符合腎臟病後期診斷之腎臟病患125名，將CKD分為3b、4及第5期共三期，經篩選與受試者同意後，蒐集身高、體重、血壓、台灣簡明版世界衛生組織生活品質分數、衰弱指數、及功能性體適能等各依變項。將腎臟疾病分期與性別、衰弱指數進行卡方檢定(Chi-Squared Test)分析及與年齡、身體質量指數進行單因子變異數(One-way ANOVA)分析之間差異，並以卡方檢定(Chi-square test)、皮爾森積差相關係數(Pearson product-moment correlation)，檢定生理指標與生活品質及功能性體適能各變項相關，再進行逐步迴歸分析(Stepwise regression analysis)探討及歸納影響生活品質與身心健康之關鍵因子。
結果：共收案98位腎臟疾病患，平均年齡76.1±7.6歲，依慢性腎臟疾病分別為3b期41人(41.8%)；4期35人(35.7%)；5期21人(22.5%)，男性與女性(56.1%：43.9%)，各項基本資料包含慢性腎臟疾病分期、性別、衰弱評估、年齡及身體質量指數。本研究合併衰弱症3b期，佔有5.1%，而非預期於第5期，腎臟疾病分期與衰弱相關為0.052，未達顯著，顯示慢性腎臟病合併衰弱並非一定是相伴的問題。分期與握力達顯著相關(F(2,95)= 5.180, p<.05)，進一步分析發現3b握力顯著高於第5期(p<.05)；身體質量指數與抓背測驗相關(F(2,95)= 4.542, p <.05)，身體質量指數27以上，上肢柔軟程度較差；性別與握力達顯著相關(F(1,96)= 97.752, p <.05)，男性握力顯著大於女性(p<.05)；年齡與心肺耐力的兩分鐘踏步顯著相關(F(4,93)= 3.289, p <.05)，經比較81歲以上者心肺功能較差；年齡與開眼單足立測驗顯著相關(F(4,93)= 6.962,p<.05)，66-70靜態平衡能力優於其他年齡層；血液指數Hb、Ca、P 、Cr皆與腎臟病分期顯相關，唯有Albumin無顯著差異。生活品質與功能性體適能個項目，進行逐步迴歸，其中在生理(Physiological)層面部分，代表動態平衡的八呎起身繞行測驗為主要預測因子F(1,96)= 6.468，p <0.05；在心理(Psychological)部分，動態平衡的八呎起身繞行測驗為預測因子F(1,96)=6.643，p <0.05；在社交(Society)部分，代表心肺耐力的兩分鐘踏步測驗為預測因子F(1,96)=6.838，p<0.05。
結論：腎臟疾病並非直接合併衰弱症的發生，仍須檢測評估，才可能診斷發現衰弱症之存在，衰弱主要與生理層面有相關，而腎臟分期的情況則與握力有顯著相關，腎臟疾病變化可能影響手臂握力程度。敏捷及動態平衡能力為慢性腎臟疾病生理及心理層面之關鍵預測因子，而社交層面之預測因子為代表心肺功能的兩分鐘踏步測驗，期望能藉此研究結果進行指標測試，俾利早期發現問題，建議未來可針對慢性腎臟疾病者之提前進行手握力、下肢動態平衡(八呎起身繞行)與心肺耐力(兩分鐘踏步)檢測，以進一步改善患者的生活品質各層面因子，並可以規劃於醫院病友會活動中進行，針對與問題相關之主題性議題宣導，提升患者對於生理、心理、社會之預防性認知，以提升日常生活動的獨立、維持良好生活品質。

Purpose：To explore the relationship between quality of life and functional health in patients with kidney disease stage 3b-5.
Method：The nephrology follow-up clinic recruited 60-year-old people who were diagnosed with end-stage renal disease, CKD3b, 4, 5. After the subject agrees, sign the consent form, and collect the subject's height, weight, blood pressure, and the score Taiwan World Health Organization Quality of Life (WHOQOL) questionnaire, frailty index and senior functional fitness test.
Results: A total of 98 patients with kidney disease were treated, with an average age of 76.1±7.6 years. According to chronic kidney disease, there were 41 (41.8%) stage 3b patients; 35 (35.7%) stage 4 patients; 21 (22.5%) stage 5 patients, male and female (56.1% vs. 43.9%). In this study, frailty combined with stage 3b, accounting for 5.1%, rather than stage 5. The correlation between kidney disease stage and frailty was 0.052, which was not significant. The eight foot up and go test was the key factors of quality of life and physiological between functional fitness by stepwise regression analysis (F(1,96) = 6.468, p<0.05; F(1,96) = 6.643 , p<0.05); The predictive factor of the Society is two-minute step test (F(1,96)=6.838, p<0.05).
Conclusions: Kidney disease is not directly related to frailty, but it is still necessary to test, evaluate, and diagnose the presence of frailty. Frailty was significantly related to the physiological level and grip strength was an important factor in the kidney disease stage.
Agility and dynamic balance are predictors of the physiological and psychological aspects of chronic kidney disease, and aerobic fitness(the two-minute walk test) is the social predictor. It is suggested that handgrip strength, dynamic balance of lower limbs, and whole-body cardiorespiratory endurance can be tested and improved in advance for patients with chronic kidney disease, so as to promote the quality of life of patients at all levels further.

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