Division of Nephrology, Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA.
Clin Transplant. 2019 Oct;33(10):e13674. doi: 10.1111/ctr.13674. Epub 2019 Aug 13.
The association between cognitive function and the likelihood of kidney transplant (KT) wait-listing, especially in minority populations, has not been clearly delineated. We performed a retrospective review of our pre-KT patients, who consist mainly of Hispanics and Native Americans, over a 16-month period. We collected data on baseline demographics and the Montreal Cognitive Assessment (MoCA) score, at the initial KT evaluation. We defined cognitive impairment as MoCA scores of <24. We constructed linear regression models to identify associations between baseline characteristics with MoCA scores and used Cox proportional hazards models to assess associations between MoCA score and KT wait-listing. During the study period, 154 patients completed the MoCA during their initial evaluation. Mean (standard deviation) MoCA scores were 23.9 (4.6), with 58 (38%) participants scoring <24. Advanced age, lower education and being on dialysis were associated with lower MoCA scores. For every one-point increase in MoCA, the likelihood of being wait-listed increased 1.10-fold (95% CI 1.01-1.19, P = .022). Being Native American and having kidney disease due to diabetes or hypertension were associated with longer time to wait-listing. Cognitive impairment was common in our pre-KT patients and was associated with a lower likelihood of KT wait-listing.
认知功能与肾移植(KT)等待名单之间的关联,特别是在少数族裔人群中,尚未得到明确阐述。我们对 16 个月期间的预 KT 患者进行了回顾性研究,这些患者主要由西班牙裔和美国原住民组成。我们收集了初步 KT 评估时的基线人口统计学数据和蒙特利尔认知评估(MoCA)评分。我们将认知障碍定义为 MoCA 评分<24。我们构建了线性回归模型来确定基线特征与 MoCA 评分之间的关联,并使用 Cox 比例风险模型来评估 MoCA 评分与 KT 等待名单之间的关联。在研究期间,154 名患者在初次评估期间完成了 MoCA。MoCA 的平均(标准差)得分为 23.9(4.6),58 名(38%)参与者的得分<24。年龄较大、教育程度较低和接受透析治疗与 MoCA 评分较低有关。MoCA 每增加 1 分,等待名单的可能性增加 1.10 倍(95%CI 1.01-1.19,P=0.022)。美国原住民以及因糖尿病或高血压导致的肾脏疾病与等待时间较长有关。认知障碍在我们的预 KT 患者中很常见,与 KT 等待名单的可能性降低有关。