Department of Nursing, Inha University, Incheon, Korea.
National Evidence-based Health Care Collaborating Agency, Seoul, Korea.
J Adv Nurs. 2019 May;75(5):962-978. doi: 10.1111/jan.13907. Epub 2019 Jan 10.
To review and identify correlates of cognitive impairment in patients with chronic kidney failure (CKF) on haemodialysis.
The literature is consistent with regard to the high prevalence of cognitive impairment among patients with CKF on haemodialysis and its dependence on multidimensional risk factors.
Systematic review and meta-analysis based on Cochrane Handbook and PRISMA.
Electronic searches of the MEDLINE, EMBASE, Cochrane Library databases and major Korean databases were used. Only original research that assessed correlates of cognitive impairment in patients with CKF on haemodialysis and published between 2004-2016 in English or Korean were included.
Studies were selected according to the PICOS: Population (chronic kidney failure patients with cognitive impairment on haemodialysis); Intervention (not applicable); Comparison (healthy controls or patients with chronic kidney failure on haemodialysis without cognitive impairment); Outcome (cognitive impairment); and Study design (primarily nonexperimental correlational studies and studies with experimental, quasi-experimental, or pre-post cohort designs). Q-test and I index were used to examine study homogeneity.
A total of 39 studies were finally included. Age, gender, stroke history, difficulties in activities of daily life, haemoglobin levels, pain, sleep difficulties, and depression were found to be significant correlates of cognitive impairment.
Nurses should be aware that the risk of cognitive impairment in patients with CKF on haemodialysis can be significantly higher for elders, women and in patients with a stroke, greater difficulties in activities of daily living, lower haemoglobin concentrations, higher pain levels, sleep difficulties, or depression.
综述并确定血液透析慢性肾衰竭（CKF）患者认知障碍的相关因素。
文献一致认为，血液透析的 CKF 患者认知障碍的发生率很高，且其取决于多种维度的危险因素。
基于 Cochrane 手册和 PRISMA 的系统评价和荟萃分析。
电子检索 MEDLINE、EMBASE、Cochrane 图书馆数据库和主要韩国数据库。仅纳入 2004-2016 年期间以英文或韩语发表的评估血液透析 CKF 患者认知障碍相关因素的原始研究。
根据 PICOS 选择研究：人群（血液透析并发认知障碍的慢性肾衰竭患者）；干预（不适用）；比较（健康对照者或无认知障碍的血液透析慢性肾衰竭患者）；结局（认知障碍）；和研究设计（主要是非实验性相关性研究和实验、准实验、或前后队列设计研究）。采用 Q 检验和 I 指数检验研究的同质性。
最终共纳入 39 项研究。年龄、性别、卒中史、日常生活活动困难、血红蛋白水平、疼痛、睡眠困难和抑郁被发现是认知障碍的显著相关因素。
护士应当知晓，对于老年人、女性以及有卒中史、日常生活活动困难更大、血红蛋白浓度更低、疼痛程度更高、睡眠困难或抑郁的血液透析 CKF 患者，其认知障碍的风险可能显著更高。
