Affiliated Hospital of Jinggangshan University, Center for Clinical Medicine Research of Jinggangshan University, Ji'an, Jiangxi Province, China.
Department of Medicine, Jinggangshan University, Ji'an, Jiangxi Province, China.
Ren Fail. 2023;45(2):2279647. doi: 10.1080/0886022X.2023.2279647. Epub 2023 Nov 15.
Since previous studies have shown a paradoxical relationship between acute kidney injury (AKI) and risk of cognitive impairment, there is an urgent need for a meta-analysis to assess the relationship between AKI and risk of cognitive impairment or dementia.
From database inception to October 2023, we searched PubMed, OVID (Medline), Embase, Web of Science, and Cochrane Library. This study examined AKI and cognitive impairment or dementia observational studies. Two authors independently assessed cohort and cross-sectional study quality using the Newcastle-Ottawa Scale and AHRQ Scale. They also used ROBINS-I to assess bias. The meta-analysis used fixed effects. Sensitivity analysis verified results stability. The funnel plot, Egger test, and Begg test determined publication bias in the results.
Seven studies with 423,876 patients were included in the meta-analysis. Patients with AKI were at higher risk of cognitive impairment or dementia compared to those who had not experienced AKI (OR = 1.87, 95% confidence interval [CI]: 1.77-1.98, I=46.0%, = 0.08). All subgroups showed a substantial connection between AKI and cognitive impairment. Compared to domestic research, the connection was stronger in overseas studies (OR = 2.18, 95% CI: 1.66-2.87). Both cognitive impairment and dementia outcomes showed a substantial connection between AKI and cognitive impairment, with OR values of 2.00 (95% CI: 1.44-2.76) and 2.04 (95% CI: 1.66-2.51).
We found that AKI significantly increases cognitive impairment or dementia risk. Thus, early interventions to delay cognitive impairment and prevent adverse outcomes in AKI patients are needed.
由于先前的研究表明急性肾损伤 (AKI) 与认知障碍风险之间存在矛盾关系，因此迫切需要进行荟萃分析来评估 AKI 与认知障碍或痴呆风险之间的关系。
从数据库建立到 2023 年 10 月，我们检索了 PubMed、OVID（Medline）、Embase、Web of Science 和 Cochrane Library。本研究调查了 AKI 和认知障碍或痴呆观察性研究。两位作者使用纽卡斯尔-渥太华量表和 AHRQ 量表独立评估队列和横断面研究的质量。他们还使用 ROBINS-I 评估偏倚。荟萃分析使用固定效应。敏感性分析验证了结果的稳定性。漏斗图、Egger 检验和 Begg 检验确定了结果中的发表偏倚。
荟萃分析纳入了 7 项包含 423876 名患者的研究。与未发生 AKI 的患者相比，发生 AKI 的患者发生认知障碍或痴呆的风险更高（OR = 1.87，95%置信区间 [CI]：1.77-1.98，I²=46.0%，P=0.08）。所有亚组均显示 AKI 与认知障碍之间存在密切关联。与国内研究相比，海外研究的关联更强（OR = 2.18，95% CI：1.66-2.87）。认知障碍和痴呆结局均显示 AKI 与认知障碍之间存在密切关联，OR 值分别为 2.00（95% CI：1.44-2.76）和 2.04（95% CI：1.66-2.51）。
我们发现 AKI 显著增加了认知障碍或痴呆的风险。因此，需要早期干预以延缓 AKI 患者的认知障碍并预防不良后果。
