Angermann Susanne, Baumann Marcus, Wassertheurer Siegfried, Mayer Christopher Clemens, Steubl Dominik, Hauser Christine, Suttmann Yana, Reichelt Anna-Lena, Satanovskij Robin, Lorenz Georg, Lukas Moritz, Haller Bernhard, Heemann Uwe, Grimmer Timo, Schmaderer Christoph
Department of Nephrology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
Department of Nephrology, Klinikum Ansbach, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen-Nuremberg, Germany.
Clin Sci (Lond). 2017 Jun 28;131(13):1483-1493. doi: 10.1042/CS20170087. Print 2017 Jul 1.
Cognitive impairment in hemodialysis patients is common and associated with adverse outcomes. So far, the underlying pathogenesis remains unclear. Therefore, we examined the potential relationship between cognitive impairment and three different categories of risk factors with particular focus on arterial stiffness measured by pulse wave velocity (PWV). A total of 201 chronic hemodialysis patients underwent cognitive testing under standardized conditions using the Montreal Cognitive Assessment (MoCA). Demographic data including cardiovascular risk factors, dialysis-associated factors as well as factors related to chronic kidney disease (CKD) were analyzed. To account for arterial stiffness, PWV was measured by ambulatory blood pressure monitoried with an oscillometric device that records brachial blood pressure along with pulse waves. In our cohort, 60.2% of patients showed pathological MoCA test results indicating cognitive impairment. PWV was significantly associated with cognitive impairment apart from age, educational level, diabetes, and hypercholesterolemia. High prevalence of cognitive impairment in hemodialysis patients was confirmed. For the first time, an association between cognitive impairment and arterial stiffness was detected in a larger cohort of hemodialysis patients. Concerning the underlying pathogenesis of cognitive impairment, current results revealed a potential involvement of arterial stiffness, which has to be further evaluated in future studies.
血液透析患者的认知障碍很常见,且与不良后果相关。到目前为止,其潜在发病机制仍不清楚。因此,我们研究了认知障碍与三类不同风险因素之间的潜在关系,特别关注通过脉搏波速度(PWV)测量的动脉僵硬度。共有201例慢性血液透析患者在标准化条件下使用蒙特利尔认知评估量表(MoCA)进行了认知测试。分析了包括心血管危险因素、透析相关因素以及与慢性肾脏病(CKD)相关的因素在内的人口统计学数据。为了评估动脉僵硬度,使用一种振荡式设备通过动态血压监测来测量PWV,该设备可记录肱动脉血压和脉搏波。在我们的队列中,60.2%的患者MoCA测试结果异常,表明存在认知障碍。除年龄、教育程度、糖尿病和高胆固醇血症外,PWV与认知障碍显著相关。血液透析患者认知障碍的高患病率得到了证实。首次在更大规模的血液透析患者队列中检测到认知障碍与动脉僵硬度之间的关联。关于认知障碍的潜在发病机制,目前的结果揭示了动脉僵硬度可能参与其中,这有待未来研究进一步评估。