Ito Hiroyuki, Antoku Shinichi, Mori Toshiko, Nakagawa Yoshitaka, Mizoguchi Katsumi, Matsumoto Suzuko, Omoto Takashi, Shinozaki Masahiro, Nishio Shinya, Abe Mariko, Mifune Mizuo, Togane Michiko
Clin Nephrol. 2018 May;89(5):330-335. doi: 10.5414/CN109188.
The association between cognitive function and clinical parameters of chronic kidney disease (CKD) was investigated in Japanese patients without overt dementia in a cross-sectional study.
A population of 497 patients whose cognitive function had been examined using the mini-mental state examination (MMSE) were screened for this study. After the exclusion of 306 subjects who showed overt dementia, the association between the MMSE score and clinical characteristics was investigated in 191 subjects (male: 55%, age: 69 ± 12 years).
The mean MMSE score of the study subjects was 26.7 ± 2.0. The MMSE score was negatively correlated with the patients' age and positively with the estimated glomerular filtration rate. It was significantly associated with age and proteinuria based on a multivariate analysis. The scores of "temporal orientation", "attention and calculation", and "remote memory" subitems of MMSE were significantly lower in the subjects ≥ 70 years of age than in those < 70 years of age. The scores of "temporal orientation" (4.3 ± 0.8 vs. 4.7 ± 0.6), "attention and calculation" (2.9 ± 1.6 vs. 3.9 ± 1.5), and "stage command" (2.7 ± 0.5 vs. 2.9 ± 0.3) were significantly lower in the subjects with proteinuria than in those without.
CONCLUSION: Cognitive function was disturbed even in CKD patients without overt dementia. Intervention in patients with risk factors is deemed important for preventing future reductions in cognitive and renal functions in CKD patients without dementia. .
在一项横断面研究中,对无明显痴呆的日本慢性肾脏病(CKD)患者的认知功能与临床参数之间的关联进行了调查。
本研究筛选了497名使用简易精神状态检查表(MMSE)检查过认知功能的患者。在排除306名有明显痴呆的受试者后,对191名受试者(男性:55%,年龄:69±12岁)的MMSE评分与临床特征之间的关联进行了调查。
研究对象的平均MMSE评分为26.7±2.0。MMSE评分与患者年龄呈负相关,与估计肾小球滤过率呈正相关。基于多变量分析,其与年龄和蛋白尿显著相关。MMSE的“时间定向”、“注意力及计算力”和“远期记忆”子项目的评分在70岁及以上的受试者中显著低于70岁以下的受试者。有蛋白尿的受试者的“时间定向”(4.3±0.8对4.7±0.6)、“注意力及计算力”(2.9±1.6对3.9±1.5)和“指令执行”(2.7±0.5对2.9±0.3)评分显著低于无蛋白尿的受试者。
即使在无明显痴呆的CKD患者中,认知功能也受到了干扰。对有危险因素的患者进行干预对于预防无痴呆的CKD患者未来认知和肾功能下降被认为是重要的。