The Research Of Relationship Between Cognitive Dysfunction And Malnutrition In Patients With Maintenance Peritoneal Dialysis

Objective To investigate the incidence of cognitive dysfunction and malnutrition in PD patients and explore the relationship between cognitive dysfunction and malnutrition in PD patients.Methods From October 2017 to October 2019,PD patients were enrolled which hospitalized in the Department of Nephrology,The Second Affiliated Hospital of Anhui Medical University.According to the Mo CA score,they were divided into the normal cognitive function group(64 cases)and the cognitive dysfunction group(57cases).The relationship among demographic characteristics,laboratory indicators and nutritional status was analyzed.Then,according to the SGA,the selected patients were divided into the normal nutrition group(27 cases),the mild-moderate malnutrition group(88 cases)and the severe malnutrition group(6 cases),analyze whether there are differences in cognitive function among the groups.Results A total of 121 PD patients were enrolled,and the cognitive impairment group was older(t=-7.34,P < 0.001),longer time for trail making test A(t=-6.30,P <0.001)and B(t=-6.30,P < 0.001),higher SGA score(t=-7.77,P < 0.001).Lower literacy(t= 3.60,P < 0.001),lower levels of hemoglobin(t=3.12,P = 0.002),lower levels of albumin(t=2.54,P = 0.012),lower levels of uric acid(t= 3.42,P= 0.001),and lower levels of lean body weight(t =2.50,P=0.014).Spearman correlation analysis showed that cognitive dysfunction was positively correlated with age(r=0.57,P<0.001),time for TMT-A(r=0.58,P<0.001),and B(r=0.58,P<0.001),and SGA score(r=0.68,P<0.001);It was negatively correlated with hemoglobin(r=-0.25,P=0.007),albumin(r=-0.27,P=0.003),uric acid(r=-0.32,P<0.001),educational level(r=-0.40,P<0.001),and lean body weight(r=-0.20,P=0.030).Multivariate Logistic regression analysis showed that SGA score(OR=1.78,95%CI=1.41 ～ 2.24,P< 0.001)and lean body weight(OR=0.87,95%CI=0.76 ～ 1.00,P=0.045)were risk factors for cognitive dysfunction.According to the SGA score,the results showed that age,education level,lean body weight,time for TMT-A,TMT-B and Mo CA score were not all equal among the three groups(P < 0.05).Then,multiple comparisons showed statistical differences in age,time for TMT-A,TMT-B,Mo CA score and education level between the normal nutrition group and the mild-moderate malnutrition group(P < 0.05).Age,lean body weight,time of TMT-A,Mo CA score,and education level were statistically different between the normal nutrition group and the severely malnourished group(P < 0.05).There were statistically significant differences in lean body weight,Mo CA score between the mild-moderate malnutrition group and the severe malnutrition group(P<0.05).An orderly Logistic regression analysis of the influencing factors of malnutrition showed that a lower assessment score of cognitive dysfunction(OR=0.14,95%CI-2.83 ～-1.10,P < 0.001),lean body weight(OR=0.88,95%CI-0.25～-0.01,P =0.032)were risks factor for malnutrition Conclusion 47.1% of PD patients had cognitive impairment.The occurrence of cognitive dysfunction in PD patients was associated with advanced age,low educational level,low lean body weight,low hemoglobin,low albumin,low uric acid and high SGA score.Malnutrition and cognitive dysfunction affect each other in pd patients,and malnutrition is a risk factor for cognitive dysfunction.