The Incidence Prognosis and Risk Factors of Cognitive Impairment in Maintenance Haemodialysis Patients

Abstract

Objective: To investigate the incidence and the prognosis of cognitive impairment (CI) and to find out the risk factors associated with the outcome in maintenance haemodialysis (MHD) patients. Methods: Enrolled the patients who met the criteria as below: MHD (≥3 months) patients before July 2014, ≥18 years old and could carry on the cognitive function test (Montreal Cognitive Assessment [MoCA]). All enrolled patients were divided into 2 groups: CI group (MoCA < 26) and non-CI group (MoCA ≥26). All patients were followed up for 36 months. The incidence, demography data, medical history, haemodialysis data, laboratory examination and prognosis of CI in haemodialysis patients were prospectively compared and analyzed. Multivariate logistic regression analysis was used to investigate the risk factors of CI. Kaplan-Meier survival curve was used for survival analysis. Results: In the present study, 219 patients were enrolled. The ratio of male to female was 1.46: 1. Age was 60.07 ± 12.44 and dialysis vintage was 100.79 ± 70.23 months. One hundred thirteen patients’ MoCA scores were lower than 26 were divided into CI group. Education status (OR 3.428), post-dialysis diastolic pressure (OR 2.234) and spKt/V (OR 1.982) were independent risk factors for CI in MHD patients. During the follow-up period, 15 patients died (13.2%) in the CI group and 5 died (4.72%) in the non-CI group (p < 0.05). The Kaplan-Meier survival curve analysis showed that the survival rate of patients with CI was lower than that of non-CI group in MHD patients during 3 years follow-up (p = 0.046). Conclusion: CI is one of the most common complications in MHD patients. The mortality is high in patients who had CI. Education status, post-dialysis diastolic pressure and spKt/V are independent risk factors for CI in MHD patients.

Cognitive Impairment and Associated Factors Among Chronic Kidney Disease Patients: A Comparative Cross-Sectional Study

“…11 The prevalence of cognitive impairment in CKD patients ranges from 17% to 87% depending on severity. [12][13][14][15][16] Its prevalence among CKD patients is 20% in the United Kingdom, 17 75.5% in China, 18 and 53.8% in India. 19 A comparative cross-sectional study in Nigeria showed that the prevalence of cognitive impairment CKD patients is 35.3% whereas for the control group it is 6%.…”

A pilot study of thiamine and folic acid in hemodialysis patients with cognitive impairment

“…It is worth mentioning that the survival rate of MHD patients with CI was signi cantly lower than that of patients with normal cognitive function, suggesting that CI is a risk factor for death of MHD patients [4] .…”

“…MoCA score which has been con rmed in the previous literature [5,6] was used to determine cognitive impairment in MHD patients in this study. Furthermore, the 3-year survival rate of MHD patients with CI was signi cantly lower than that of patients with normal cognitive function [4] .…”

“…Cognitive Impairment (CI) is one of the common neurological complications in patients with ESRD [3] . Our previous single-center cohort observational study showed that the incidence of CI in patients with maintenance hemodialysis (MHD) was 51.6% and 3 times higher than that of non-Kidney disease patients [4] . MoCA score which has been con rmed in the previous literature [5,6] was used to determine cognitive impairment in MHD patients in this study.…”

A pilot study of thiamine and folic acid in hemodialysis patients with cognitive impairment

“…Cognitive Impairment (CI) is one of the common neurological complications in patients with ESRD [3] . Our previous single-center cohort observational study showed that the incidence of CI in patients with maintenance hemodialysis (MHD) was 51.6% and 3 times higher than that of non-Kidney disease patients [4] . The 3-year survival rate of MHD patients with CI was signi cantly lower than that of patients with normal cognitive function [4] .…”