School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
School of Nursing, Peking University, Beijing, China.
J Adv Nurs. 2023 Oct;79(10):3691-3706. doi: 10.1111/jan.15746. Epub 2023 Jun 26.
To systematically identify the risk factors for cognitive impairment in maintenance haemodialysis patients and to assess its prevalence in included studies.
Systematic review and meta-analysis about observational studies.
Systematic search of seven databases, including PubMed, Web of Science, Scope, Wanfang Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and Weipu Chinese Science and Technology Journal Database, from inception until October 2021.
Observational studies reporting the risk factors for cognitive impairment in maintenance haemodialysis patients in English and Chinese language were included. Meta-analysis was performed to identify risk factors and prevalence of cognitive impairment in maintenance haemodialysis patients with STATA 15.0 software.
Overall, 37 eligible studies encompassing 129,849 cases were included. The risk factors with statistical significance after meta-analysis were older age, female sex, fewer years of education, hypertension, diabetes, cerebrovascular accident, multiple comorbid conditions, systolic blood pressure variability, arterial stiffness and low haemoglobin and albumin level. The overall prevalence of cognitive impairment in maintenance haemodialysis patients was 49.1%.
The current analysis indicated a high prevalence of cognitive impairment in maintenance haemodialysis patients. Eleven risk factors for cognitive impairment in maintenance haemodialysis patients were identified, among which more attention should be paid to modifiable factors such as cardiovascular disease risk factors and specific kidney and dialysis-related factors.
This paper provides an updated estimate of the pooled prevalence of cognitive impairment in maintenance haemodialysis patients. Identification of risk factors associated with cognitive impairment may assist in developing targeted prevention strategies for maintenance haemodialysis patients at high risk.
This study was a systematic review completed by the authors in accordance with relevant guidelines and processes and did not include the participation of patients, service users, caregivers or the general public.
系统识别维持性血液透析患者认知障碍的危险因素，并评估纳入研究的认知障碍患病率。
对观察性研究进行系统综述和荟萃分析。
系统检索了 7 个数据库，包括 PubMed、Web of Science、Scope、万方数据库、中国知识基础设施、中国生物医学文献数据库和维普中文科技期刊数据库，检索时间从建库至 2021 年 10 月。
纳入了用英文和中文报告维持性血液透析患者认知障碍危险因素的观察性研究。使用 STATA 15.0 软件进行荟萃分析，以确定维持性血液透析患者认知障碍的危险因素和患病率。
共纳入 37 项符合条件的研究，包含 129849 例患者。荟萃分析后有统计学意义的危险因素包括年龄较大、女性、受教育年限少、高血压、糖尿病、脑血管意外、多种合并症、收缩压变异性、动脉僵硬度以及低血红蛋白和白蛋白水平。维持性血液透析患者认知障碍的总体患病率为 49.1%。
目前的分析表明，维持性血液透析患者认知障碍的患病率较高。确定了 11 个与维持性血液透析患者认知障碍相关的危险因素，其中应更加关注心血管疾病危险因素和特定的肾脏及透析相关因素等可改变的因素。
本文提供了维持性血液透析患者认知障碍的汇总患病率的最新估计值。识别与认知障碍相关的危险因素可能有助于为高风险的维持性血液透析患者制定有针对性的预防策略。
本研究是作者根据相关指南和流程完成的系统评价，不包括患者、服务使用者、护理人员或公众的参与。
