活体肾捐献后认知功能评估：一项横断面初步研究。
Assessment of cognitive functioning after living kidney donation: A cross-sectional pilot study.
机构信息
Department of Neurology, Hannover Medical School, Hannover, Germany.
Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.
出版信息
PLoS One. 2022 Feb 25;17(2):e0264284. doi: 10.1371/journal.pone.0264284. eCollection 2022.
BACKGROUND
Chronic kidney disease (CKD) has emerged as a risk factor for cognitive impairment. Living kidney donation results in reduction of the donors' renal function. This is considered acceptable in general but possible associations with cognitive function have not yet been studied.
METHODS
Sixty living kidney donors (LKD), who had donated between 2003 and 2012 at Hannover Medical School, underwent neurocognitive testing including attentional and memory testing. In a cross-sectional design results were compared with data of healthy controls (n = 40) and with norm data given in the respective test manuals adjusted for age, sex, and education.
RESULTS
The median age of the LKD was 58 (range 39-70) years and the median time since donation was 7 (range 4-14) years. The LKD did not differ from controls in most of the cognitive test results and a composite attention test sum score. However, LKD did worse than controls in tests of working memory, parallel processing of stimuli, and sustained attention. No differences were found regarding quality of life. In LKD cognitive test results correlated significantly only with educational level but not with time since transplantation, eGFR, somatic comorbidity, quality of life and levels of fatigue, distress, depression, and anxiety.
CONCLUSIONS
Our data show a fairly normal performance of LKD in most attentional and memory tests. However, our pilot study also suggests some cognitive impairment in attention tests in LKD which would need to be confirmed in longitudinal prospective studies.
背景
慢性肾脏病（CKD）已成为认知障碍的一个危险因素。活体肾捐献会导致捐献者的肾功能下降。一般来说，这是可以接受的，但与认知功能的可能关联尚未得到研究。
方法
60 名在汉诺威医学院进行活体肾捐献的捐献者（LKD），于 2003 年至 2012 年期间进行了神经认知测试，包括注意力和记忆力测试。在横断面设计中，将结果与健康对照组（n = 40）的数据以及根据年龄、性别和教育程度在各自测试手册中调整的正常数据进行了比较。
结果
LKD 的中位年龄为 58 岁（范围 39-70 岁），中位捐献时间为 7 年（范围 4-14 年）。LKD 在大多数认知测试结果和注意力测试总和评分方面与对照组没有差异。然而，LKD 在工作记忆、刺激的并行处理和持续注意力测试方面的表现不如对照组。两组之间的生活质量没有差异。在 LKD 中，认知测试结果仅与教育程度显著相关，而与移植后时间、eGFR、躯体合并症、生活质量以及疲劳、痛苦、抑郁和焦虑水平无关。
结论
我们的数据显示，LKD 在大多数注意力和记忆测试中表现相当正常。然而，我们的初步研究还表明，LKD 在注意力测试中存在一些认知障碍，这需要在纵向前瞻性研究中得到证实。
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