Department of Psychiatry, Kyungpook National University Hospital, Daegu, Korea.
J Am Geriatr Soc. 2011 Sep;59(9):1628-35. doi: 10.1111/j.1532-5415.2011.03562.x. Epub 2011 Aug 24.
To investigate the nature of frontal dysfunction associated with chronic kidney disease (CKD) in people without stroke or depressive disorders.
Cross-sectional.
Community based.
Five hundred twenty-nine community-dwelling participants.
Participants with CKD were classified into one of three diagnostic groups based on their estimated glomerular filtration rate (eGFR): normal (≥ 60.0 mL/min per 1.73 m(2)), mild CKD (45.0-59.9 mL/min per 1.73 m(2)), or moderate to severe CKD (<45.0 mL/min per 1.73 m(2)). Cognitive function was assessed using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery, lexical fluency, digit span test, and the 64-card Wisconsin Card Sorting Test.
Perseverative responses and perseverative errors were significantly more prevalent in the group with moderate to severe CKD than in those without CKD and those with mild CKD. The mean number of perseverative responses was 28.6 ± 16.9 in participants with moderate to severe CKD, 19.0 ± 11.4 in those with mild CKD, and 17.1 ± 10.6 in those without CKD (P < .001, ANCOVA). The mean number of perseverative errors was 23.1 ± 12.3 in participants with moderate to severe CKD, 16.2 ± 8.3 in those with mild CKD, and 14.8 ± 7.8 in those without CKD (P < .001, analysis of covariance). The odds ratios in the fully adjusted model for the presence of moderate to severe CKD for perseverative responses and perseverative errors were 4.82 (95% confidence interval (CI) = 2.14-10.85, P < .001) and 5.01 (95% CI = 2.22-11.28, P<.001), respectively.
Frontal dysfunction, particularly perseverative errors and responses, was associated with moderate to severe CKD in the population studied.
研究无中风或抑郁障碍的慢性肾脏病（CKD）患者额叶功能障碍的性质。
横断面研究。
社区为基础。
529 名居住在社区的参与者。
根据估计肾小球滤过率（eGFR）将 CKD 患者分为三组：正常（≥60.0mL/min/1.73m²）、轻度 CKD（45.0-59.9mL/min/1.73m²）或中重度 CKD（<45.0mL/min/1.73m²）。使用韩国版 Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery、词汇流畅性、数字跨度测试和 64 张威斯康星卡片分类测试评估认知功能。
中重度 CKD 组的持续反应和持续错误明显多于无 CKD 组和轻度 CKD 组。中重度 CKD 组的持续反应均值为 28.6±16.9，轻度 CKD 组为 19.0±11.4，无 CKD 组为 17.1±10.6（P<0.001，协方差分析）。中重度 CKD 组的持续错误均值为 23.1±12.3，轻度 CKD 组为 16.2±8.3，无 CKD 组为 14.8±7.8（P<0.001，协方差分析）。在调整后的完全模型中，中重度 CKD 患者持续反应和持续错误的存在的比值比分别为 4.82（95%置信区间（CI）=2.14-10.85，P<0.001）和 5.01（95%CI=2.22-11.28，P<.001）。
在研究人群中，额叶功能障碍，特别是持续错误和反应，与中重度 CKD 相关。
