Hung Peir-Haur, Yeh Chih-Ching, Hsiao Chih-Yen, Sung Pi-Shan, Muo Chih-Hsin, Sung Fung-Chang, Hung Kuan-Yu, Tsai Kuen-Jer
Department of Internal Medicine, Ditmanson Medical Foundation Chia-yi Christian Hospital, Chia-yi, Taiwan.
Department of Applied Life Science and Health, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan.
Oncotarget. 2017 Nov 15;8(64):107348-107355. doi: 10.18632/oncotarget.22458. eCollection 2017 Dec 8.
There is controversy regarding the extent of risk for dementia in patients with end stage renal disease (ESRD) who are undergoing hemodialysis (HD) or peritoneal dialysis (PD). We examined data from Taiwan's Longitudinal Health Insurance Database, and used Cox proportional hazard regression analysis to compare the development of dementia in 72,934 HD and PD patients with 72,934 matched controls from January 1, 1999 to December 31, 2010. The results indicate an increased risk for dementia overall in HD patients (adjusted hazard ratio [aHR] = 1.64, < 0.0001) and PD patients (aHR = 2.21, < 0.0001). HD and PD patients also had significantly greater aHRs for vascular dementia (VaD) and unspecified dementia (UnD), but only HD patients had a significantly greater aHR for Alzheimer's disease (AD). Further research is needed to confirm whether management of ESRD with PD can reduce the incidence of AD, and to identify the mechanisms by which ESRD increases the risk of dementia.
对于正在接受血液透析（HD）或腹膜透析（PD）的终末期肾病（ESRD）患者患痴呆症的风险程度存在争议。我们研究了台湾纵向健康保险数据库的数据，并使用Cox比例风险回归分析，比较了1999年1月1日至2010年12月31日期间72,934名HD和PD患者与72,934名匹配对照者痴呆症的发病情况。结果表明，HD患者（校正风险比[aHR]=1.64，<0.0001）和PD患者（aHR=2.21，<0.0001）总体患痴呆症的风险增加。HD和PD患者患血管性痴呆（VaD）和未分类痴呆（UnD）的aHR也显著更高，但只有HD患者患阿尔茨海默病（AD）的aHR显著更高。需要进一步研究以确认PD治疗ESRD是否可以降低AD的发病率，并确定ESRD增加痴呆症风险的机制。
