Acute variation in cognitive function in hemodialysis patients: A cohort study with repeated measures
Acute variation in cognitive function in hemodialysis patients: A cohort study with repeated measures
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DOI：
10.1053/j.ajkd.2007.05.010
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发表时间：
2007-08-01
影响因子：
13.2
通讯作者：
Foley, Robert N.
中科院分区：
文献类型：
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作者：
Murray, Anne M.;Pederson, Sarah L.;Foley, Robert N.
背景资料：虽然血液透析患者的认知功能被认为是最好的透析后24小时，在透析周期的变化程度是unknow.Study设计：重复测量队列研究。设置和参与者：血液透析中心;患者年龄55岁或以上。预测因子：与透析疗程相关的评估时间。时间1（T1）发生在透析前约1小时; T2，透析后1小时; T3，透析后1小时; T4，第二天。结果：使用45分钟认知电池测量认知功能。计算平均综合得分以测量整体认知功能，等于每个测试时间的所有测试的受试者标准化得分的平均值。根据综合评分将时间分为最佳和最差。测量：平均在2次透析中进行测试，以避免测试疲劳。认知电池包括测试的语言流畅性，即时和延迟的语言和视觉记忆，和执行功能，管理在4 times.Results：在28名受试者谁完成了测试在3或4个测试时间，平均年龄为66.7 +/- 9.5年，平均透析年份为44.7 +/- 33.3个月。使用相关数据的一般线性模型，透析期间（T2）的综合评分显著低于（较差）治疗前不久（T1）或第二天（T4;两者P < 0.001）。局限性：样本量相对较小，测试延迟，结果可能无法推广。整体认知功能在透析周期中变化显著，在透析期间最差，在透析前不久或透析后一天最好。在这些时候，临床医生的访问可能是最有效的。美国肾脏病杂志50：270-278。(c)2007年，美国国家肾脏基金会（National Kidney Foundation，Inc.）
Background: Although cognitive function in hemodialysis patients is believed to be best 24 hours after the dialysis session, the extent of variation during the dialysis cycle is unknown.Study Design: Cohort study with repeated measures.Setting & Participants: Hemodialysis centers; patients aged 55 years or older. Predictor: Time of assessment related to the dialysis session. Time 1 (T1) occurred approximately 1 hour before the dialysis session; T2, 1 hour into the session; T3, 1 hour after; and T4, the next day.Outcomes: Measures of cognitive function using a 45-minute cognitive battery. An average composite score was calculated to measure global cognitive function, equal to the average of subjects' standardized scores on all tests given at each test time. Times were classified as best and worst according to composite scores.Measurements: Testing was conducted on average over 2 dialysis sessions to avoid test fatigue. The cognitive battery included tests of verbal fluency, immediate and delayed verbal and visual memory, and executive function, administered at 4 times.Results: In the 28 subjects who completed testing at 3 or 4 testing times, mean age was 66.7 +/- 9.5 years and mean dialysis vintage was 44.7 +/- 33.3 months. Using a general linear model for correlated data, the composite score was significantly lower (poorer) during dialysis (T2) than shortly before the session (T1) or on the next day (T4; P < 0.001 for both).Limitations: Relatively small sample size, testing delays, results may not be generalizable.Conclusion: Global cognitive function varies significantly during the dialysis cycle, being worst during dialysis and best shortly before the session or on the day after. Clinician visits may be most effective at these times.Am J Kidney Dis 50:270-278. (c) 2007 by the National Kidney Foundation, Inc.