The Risk Factors Of Cognitive Impairment In Patients With Chronic Kidney Disease: A Meta-analysis

Background: With the incidence of chronic kidney disease(CKD)dramatically increasing,it has become a major health issue in the world.Meanwhile,the incidence of cognitive impairment is another feared problem to CKD patients,because this change has happened at the early stage of kidney disease.When these patients suffer other risk factors,like hypertension,diabetes,coronary heart disease,the incidence of cognitive decline is higher than the pure one of CKD.But there is little evidence on how the incidence will be changed according to different risk factors among CKD patients.Method: A total of 16 studies including 138,943 participants were searched and analyzed from Pub Med and Embase databases(from inception to November 2016).Rev Man 5.3 was used to analyze these data.Results: According to the result of meta-analysis,hypertension and diabetes were significant risk factors in cognitive function reduction and cognitive function declined significantly among CKD patients with hypertension or diabetes(hypertension,OR=1.33,95% CI,1.26 to 1.53;p<0.0001;diabetes,OR=1.39,95% CI,1.16 to 1.53;p<0.00001).But the one suffered diabetes,the cognitive function declined more serious than the one suffered hypertension(p=0.02;OR=1.16;95%CI 1.02 to 1.33).Conclusion: Diabetes or hypertension are both of risk factors to CKD patients' cognitive function,but the incidence is higher in diabetes one.Objective To discuss risk factors of cognitive impairment in elderly patients with maintenance hemodialysis(MHD).Methods Cognitive function was measured by Montreal Cognitive Assessment(Mo CA)among 105 aged patients with MDH.According to the score of Mo CA assessment,these patients were divided into 2 groups,the non-cognitive function one(group A),and the cognitive dysfunction one(group B).These data were analyzed by t-test,X2-test and multiple logisitic regression analysis to discover the relative risk factors.Results Among these patients,55 patients gained score above 26,the proportion of cognitive impairment was 52.38%.But there were no significant difference among gender,age,years of education,serum calcium,FBG and fasting insulin in two groups(p>0.05).Multiple regression analysis showed that hemoglobin,fasting C-Peptide and body weight change after hemodialysis were considered as the independent risk factors among MHD patients with cognitive dysfunction(p<0.05).Conclusion It is a high incidence of cognitive dysfunction in elderly MHD patients.Cognitive dysfunction has strong ties with anemia,insulin resistance and weight change during the process of hemodialysis.