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视网膜病变与腹膜透析患者认知障碍有关。

Retinopathy is associated with impaired cognition in patients undergoing peritoneal dialysis.

机构信息

Department of Nephropathy, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.

Division of Nephrology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China.

出版信息

Ren Fail. 2023;45(2):2258989. doi: 10.1080/0886022X.2023.2258989. Epub 2023 Sep 21.

Abstract

Previous studies have shown a relationship between retinopathy and cognition including population with and without chronic kidney disease (CKD) but data regarding peritoneal dialysis (PD) are limited. This study aims to investigate the relationship between retinopathy and cognitive impairment in patients undergoing peritoneal dialysis (PD). In this observational study, we recruited a total of 107 participants undergoing PD, consisting of 48 men and 59 women, ages ranging from 21 to 78 years. The study followed a cross-sectional design. Retinal microvascular characteristics, such as geometric changes in retinal vascular including tortuosity, fractal dimension (FD), and calibers, were assessed. Retinopathy (such as retinal hemorrhage or microaneurysms) was evaluated using digitized photographs. The Modified Mini-Mental State Examination (3MS) was performed to assess global cognitive function. The prevalence rates of retinal hemorrhage, microaneurysms, and retinopathy were 25%, 30%, and 43%, respectively. The mean arteriolar and venular calibers were 63.2 and 78.5 µm, respectively, and the corresponding mean tortuosity was 37.7 ± 3.6 and 37.2 ± 3.0 mm. The mean FD was 1.49. After adjusting for age, sex, education, mean arterial pressure, and Charlson index, a negative association was revealed between retinopathy and 3MS scores (regression coefficient: -3.71, 95% confidence interval: -7.09 to -0.33,  = 0.03). Retinopathy, a condition common in patients undergoing PD, was associated with global cognitive impairment. These findings highlight retinopathy, can serve as a valuable primary screening tool for assessing the risk of cognitive decline.

摘要

先前的研究表明,视网膜病变与认知功能之间存在关联,包括患有和不患有慢性肾脏病(CKD)的人群,但有关腹膜透析(PD)的数据有限。本研究旨在探讨腹膜透析患者中视网膜病变与认知障碍之间的关系。在这项观察性研究中,我们共招募了 107 名接受 PD 的患者,其中包括 48 名男性和 59 名女性,年龄在 21 至 78 岁之间。研究采用横断面设计。评估了视网膜微血管特征,如视网膜血管的几何变化,包括迂曲度、分形维数(FD)和口径。使用数字化照片评估视网膜病变(如视网膜出血或微动脉瘤)。采用改良的简易精神状态检查(3MS)评估整体认知功能。视网膜出血、微动脉瘤和视网膜病变的患病率分别为 25%、30%和 43%。动、静脉平均口径分别为 63.2 和 78.5μm,相应的平均迂曲度为 37.7±3.6 和 37.2±3.0mm。平均 FD 为 1.49。在校正年龄、性别、教育程度、平均动脉压和 Charlson 指数后,发现视网膜病变与 3MS 评分呈负相关(回归系数:-3.71,95%置信区间:-7.09 至 -0.33,=0.03)。在接受 PD 的患者中常见的视网膜病变与整体认知障碍有关。这些发现强调了视网膜病变可以作为评估认知能力下降风险的有价值的初步筛查工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0e1/10515682/3c5d7496fb9e/IRNF_A_2258989_F0001_B.jpg

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