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血液透析与肾移植对终末期肾病患者认知功能影响的比较研究

Comparative study of impact of hemodialysis and renal transplantation on cognitive functions in ESRD patients.

作者信息

Anwar Waleed, Ezzat Haitham, Mohab Amr

机构信息

Department of Nephrology, Ain Shams University, Cairo, Egypt.

Department of Nephrology, Ain Shams University, Cairo, Egypt.

出版信息

Nefrologia. 2015 Nov-Dec;35(6):567-71. doi: 10.1016/j.nefro.2015.07.004. Epub 2015 Oct 3.

Abstract

UNLABELLED

Cognitive impairment is defined as a newly appeared deficit in at least two areas of cognitive functions, including disturbances in memory, executive functioning, attention or speed of information processing, perceptual motor abilities, or language. Cognitive impairment is highly prevalent in ESRD patients when compared with the general population. It has also been associated with a decreased quality of life. Cognitive functions in patients with ESRD showed improvement with dialysis and renal transplantation. These findings illustrate the potential importance of evaluating and comparing the effects of hemodialysis and transplantation regarding cognitive performance and thus quality of life in ESRD patients and normal subjects. This study was carried out in 100 patients (50 ESRD patients on regular hemodialysis for at least 6 months and 50 post-transplant patients who had maintained successful kidney graft for at least 3 months). All patients underwent laboratory and psychometric scoring tests, including trail making test part A, trail making test part B, digit span, and mini-mental state examination. Thirty healthy adults matched by age and sex served as a control group. The results showed significant differences in cognitive function tests results between transplant and hemodialysis patients (P<0.01), suggesting that transplant patients were superior in their cognitive performance, with the correction of anemia being the most important factor for improving cognitive performance in both groups. There were no significant differences between transplant patients and control subjects in psychometric measures (P>0.05).

CONCLUSION

Renal transplantation as a modality of treatment, in ESRD patients, is superior to hemodialysis in terms of cognitive performance improvement.

摘要

未标注

认知障碍被定义为至少在两个认知功能领域新出现的缺陷,包括记忆、执行功能、注意力或信息处理速度、感知运动能力或语言方面的障碍。与普通人群相比,认知障碍在终末期肾病(ESRD)患者中非常普遍。它还与生活质量下降有关。ESRD患者的认知功能在透析和肾移植后有所改善。这些发现说明了评估和比较血液透析和移植对认知表现的影响以及对ESRD患者和正常受试者生活质量影响的潜在重要性。本研究对100名患者进行(50名接受定期血液透析至少6个月的ESRD患者和50名肾移植成功至少3个月的移植后患者)。所有患者均接受实验室和心理测量评分测试,包括数字连接试验A部分、数字连接试验B部分、数字广度和简易精神状态检查。30名年龄和性别匹配的健康成年人作为对照组。结果显示,移植患者和血液透析患者在认知功能测试结果上存在显著差异(P<0.01),表明移植患者的认知表现更优,纠正贫血是两组改善认知表现的最重要因素。移植患者和对照受试者在心理测量指标上无显著差异(P>0.05)。

结论

作为一种治疗方式,肾移植在改善ESRD患者的认知表现方面优于血液透析。

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