Tsai Hsin-Hsi, Yen Ruoh-Fang, Lin Cheng-Li, Kao Chia-Hung
Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan.
PLoS One. 2017 Feb 13;12(2):e0171671. doi: 10.1371/journal.pone.0171671. eCollection 2017.
To determine whether acute kidney injury (AKI) is a risk factor for dementia.
This nationwide population-based cohort study was based on data from the Taiwan National Health Insurance Research Database for 2000-2011. The incidence and relative risk of dementia were assessed in 207788 patients hospitalized for AKI. The comparison control was selected using the propensity score based on age, sex, index year and comorbidities.
During the 12-year follow-up, patients with AKI had a significantly higher incidence for developing dementia than did the controls (8.84 vs 5.75 per 1000 person-y). A 1.88-fold increased risk of dementia (95% confidence interval, 1.76-2.01) was observed after adjustment for age, sex, and several comorbidities (diabetes, hypertension, hyperlipidemia, head injury, depression, stroke, chronic obstructive pulmonary disease, coronary artery disease, congestive heart failure, atrial fibrillation, cancer, liver disease, chronic infection/inflammation, autoimmune disease, malnutrition).
We found that patients with AKI exhibited a significantly increased risk of developing dementia. This study provides evidence on the association between AKI and long-term adverse outcomes. Additional clinical studies investigating the related pathways are warranted.
确定急性肾损伤（AKI）是否为痴呆的危险因素。
这项基于全国人群的队列研究基于2000 - 2011年台湾国民健康保险研究数据库的数据。对207788例因AKI住院的患者评估痴呆的发病率和相对风险。使用基于年龄、性别、索引年份和合并症的倾向评分选择对照。
在12年的随访期间，AKI患者发生痴呆的发病率显著高于对照组（每1000人年分别为8.84例和5.75例）。在调整年龄、性别和几种合并症（糖尿病、高血压、高脂血症、头部损伤、抑郁症、中风、慢性阻塞性肺疾病、冠状动脉疾病、充血性心力衰竭、心房颤动、癌症、肝病、慢性感染/炎症、自身免疫性疾病、营养不良）后，观察到痴呆风险增加了1.88倍（95%置信区间，1.76 - 2.01）。
我们发现AKI患者发生痴呆的风险显著增加。本研究为AKI与长期不良结局之间的关联提供了证据。有必要进行更多研究相关途径的临床研究。
