Cognitive impairment in peritoneal dialysis patients.
Cognitive impairment in peritoneal dialysis patients.
复制标题
腹膜透析患者的认知障碍。
DOI：
10.1053/j.ajkd.2010.11.026
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发表时间：
2011-04
期刊：
影响因子：
--
通讯作者：
Murray AM
中科院分区：
文献类型：
--
作者：
Kalirao P;Pederson S;Foley RN;Kolste A;Tupper D;Zaun D;Buot V;Murray AM
血液透析患者中中度到重度认知障碍的患病率是普通人群的两倍多。这项研究描述了腹膜透析队列与非慢性肾脏疾病(CKD)队列中认知损害的发生情况。横断面研究。来自两个城市透析单位的51名讲英语的腹膜透析患者，与来自16个城市透析单位的338名血液透析患者和来自城市普通内科诊所的101名无慢性肾脏病的志愿者进行对照。一组45分钟的九项经过验证的神经心理测试(认知域记忆、执行功能、语言)。轻度、中度或重度认知障碍，根据先前设计的算法进行分类。在腹膜透析组中，33.3%的患者有无或轻度认知障碍，35.3%的患者有中度认知障碍，31.4%的患者有重度认知障碍；相应的数值在非慢性肾脏病患者组中为60.4%、26.7%和12.9%，在血液透析组中为26.6%、36.4%和37.0%。包括年龄、性别、种族、教育程度、血红蛋白、糖尿病和中风在内的Logistic回归模型显示，在腹膜透析队列中，只有非白人(P=0.002)和教育程度(P=0.002)与中度到重度认知损害相关。与血液透析患者相比，腹膜透析患者中有更多的人有中度到重度的记忆障碍(60%比52%)，但执行功能受损的人更少(三分之一比一半)。在调整后的Logistic回归模型中，腹膜透析与中度到重度认知损害的风险增加2.5倍以上(OR，2.58；95%可信区间1.02-6.53)，血液透析也是如此(OR，3.16；95%CI，1.91-5.24)。样本量小，参与率偏低。与血液透析患者类似，三分之二的腹膜透析患者有中度至严重的认知障碍，足以干扰安全的自我透析和坚持复杂的药物治疗方案。这些患者可以在透析开始前和透析后定期进行认知评估。
Prevalence of moderate to severe cognitive impairment among hemodialysis patients is more than double the prevalence in the general population. This study describes cognitive impairment occurrence in a peritoneal dialysis cohort compared with a cohort without chronic kidney disease (CKD). Cross-sectional study. 51 English-speaking peritoneal dialysis patients from two urban dialysis units, compared with 338 hemodialysis patients from 16 urban dialysis units and 101voluntary controls without CKD from urban general medicine clinics. A 45-minute battery of nine validated neuropsychological tests (cognitive domains memory, executive function, language). Mild, moderate, or severe cognitive impairment, classified according to a previously designed algorithm. Of the peritoneal dialysis cohort, 33.3% had no or mild, 35.3% moderate, and 31.4% severe cognitive impairment; corresponding values were 60.4%, 26.7%, and 12.9% of the non-CKD cohort, and 26.6%, 36.4%, and 37.0% of the hemodialysis cohort. A logistic regression model including age, sex, race, education, hemoglobin, diabetes, and stroke showed that only non-white race (P = 0.002) and education (P = 0.002) were associated with moderate to severe cognitive impairment in the peritoneal dialysis cohort. Compared with hemodialysis patients, more peritoneal dialysis patients had moderate to severe memory impairment (60% vs. 52%), but fewer had impaired executive function (one-third vs. one-half). Peritoneal dialysis was associated with a more than 2.5-fold increased risk of moderate to severe cognitive impairment compared with no CKD (OR, 2.58; 95% confidence interval 1.02-6.53), as was hemodialysis (OR, 3.16; 95% CI, 1.91-5.24), in an adjusted logistic regression model. Small sample size, participation rate somewhat low. Similar to hemodialysis patients, two-thirds of peritoneal dialysis patients had moderate to severe cognitive impairment, enough to interfere with safely self-administering dialysis and adhering to complex medication regimens. These patients could benefit from cognitive assessment before and periodically after dialysis initiation.
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影响因子：
8.3
作者：
HATA, R;MATSUMOTO, M;KAMADA, T
通讯作者：
KAMADA, T
影响因子：
13.2
作者：
Collins, AJ;Li, SL;Herzog, C
通讯作者：
Herzog, C
DOI：
10.1111/j.1532-5415.1992.tb01796.x
发表时间：
1992-11-01
影响因子：
6.3
作者：
MENDEZ, MF;ALA, T;UNDERWOOD, KL
通讯作者：
UNDERWOOD, KL
影响因子：
120.7
作者：
EVANS, DA;FUNKENSTEIN, H;TAYLOR, JO
通讯作者：
TAYLOR, JO
影响因子：
6.7
作者：
Perneczky, R;Pohl, C;Kurz, A
通讯作者：
Kurz, A