The Comparative Study Of The Prevalence Of Cognitive Impairment In Maintenance Hemodialysis Patients And Peritoneal Dialysis Patients

Objective: To study the prevalence of cognitive impairment(CI)and its risk factors of hemodialysis(HD)patients and peritoneal dialysis(PD)patients in Hebei General Hospital,find the ways of preventing CI and delaying CI progress in dialysis patients and enhance medical workers’ awareness of CI in dialysis patients.Methods: Sixty-eight patients with HD(group A)and forty-five patients with PD(group B)who were re-examined in the outpatient service of Hebei General Hospital from June 2019 to January 2020 were selected.According to the Montreal Cognitive Assessment(Mo CA)score,the A and B groups were divided into CI group and non-CI group: ACI group and A non-CI group,BCI group and B non-CI group.Age,gender,years of education,working status,duration of dialysis,primary disease,comorbidities,the presence or absence of urine volume,blood pressure and other clinical data were gathered.We recorded laboratory indicators such as blood analysis,biochemical analysis,and iron metabolism.Results: 1.There was no significant difference in age,gender,years of education and working status between the two groups of patients A and B(P≥0.05).The χ2 test was used to analyze the two groups A and B.The difference in CI prevalence between the two groups was statistically significant(P<0.05).The CI prevalence of group B in our hospital was lower than that of group A.2.Comparing the data between ACI group and A non-CI group,the results showed that the differences of age,gender,employment or not,education≥12 years or not,pre-dialysis diastolic pressure,post-dialysis diastolic pressure,serum phosphorus level and glucose were statistically significant(P<0.05 or P<0.01),and the differences in the other indicators were not statistically significant(P≥0.05).The above statistically significant indicators were included in the binary logistic regression analysis.The results showed that employment or not,education≥12 years or not,serum phosphorus level were significant differences in the two groups(P<0.05),and the other indicators were not statistically significant(P≥0.05).3.The results showed that the differences of age,diastolic pressure,employment or not,whether the education years≥12 years,intact parathyroid hormone(i PTH)and albumin(Alb)between BCI group and B non-CI group were statistically significant(P<0.05 or P<0.01),and the differences in other indicators were not statistically significant(P≥0.05).The above statistically significant indicators were included in the binary logistic regression analysis.And the results showed that the difference between the presence and absence of work was statistically significant(P<0.05),and the other indicators were not statistically significant(P≥0.05).Conclusions: 1.CI is one of the common complications in dialysis patients.The prevalence of CI in PD patients in our hospital is lower than that in HD patients.2.Age,gender,employment or not,education≥12 years or not,pre-dialysis and post-dialysis diastolic pressure,serum phosphorus level and glucose may be related to the occurrence of CI in HD patients.Age,diastolic pressure,employment or not,whether the education years≥12 years,i PTH and Alb may be the influencing factors of CI in PD patients.Employment or not in both HD and PD patients is an independent risk factor for CI.In addition,in patients with HD,years of education<12 years and the lower serum phosphorus level are also independent risk factors for CI.