慢性肾脏病患者认知障碍的患病率及其预测因素：系统评价和荟萃分析。

Prevalence of cognitive impairment and its predictors among chronic kidney disease patients: A systematic review and meta-analysis.

机构信息

Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China.

The National Clinical Research Center for Geriatric Disease, Xuanwu Hospital, Capital Medical University, Beijing, China.

出版信息

PLoS One. 2024 Jun 3;19(6):e0304762. doi: 10.1371/journal.pone.0304762. eCollection 2024.

DOI:10.1371/journal.pone.0304762

PMID:38829896

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11146742/

Abstract

BACKGROUND

Cognitive impairment (CI) is common among patients with chronic kidney disease (CKD), and is associated with a poor prognosis. We assessed the prevalence and associated factors of CI in patients with CKD.

METHODS

A systematic review and meta-analysis were conducted by searching PubMed, Embase, and the Web of Science through December 1, 2023. Random effects models were performed with subgroup analyses to further explore the heterogeneity.

RESULTS

50 studies involving 25,289 CKD patients were included. The overall prevalence of CI was 40% (95% confidence interval 33-46). The pooled prevalence of CI was relatively higher in CKD patients from Africa (58%), Asia (44%) and America (37%). Attention and executive dysfunction appeared to be the most common manifestations. The prevalence of CI was higher among patients with hemodialysis (53%) and peritoneal dialysis (39%) than those without dialysis (32%) and post-kidney transplanted (26%). In addition, advanced age, the presence of diabetes and hypertension might increase the risk of CI in CKD patients.

CONCLUSIONS

People with CKD have a high prevalence of CI, especially in patients with hemodialysis. An early and comprehensive screening for CI in CKD patients is needed to improve clinical outcomes.

TRIAL REGISTRATION

Registration number: PROSPERO (CRD42023412864).

摘要

背景

认知障碍（CI）在慢性肾脏病（CKD）患者中很常见，与预后不良有关。我们评估了 CKD 患者 CI 的患病率和相关因素。

方法

通过检索 PubMed、Embase 和 Web of Science，于 2023 年 12 月 1 日进行了系统评价和荟萃分析。采用随机效应模型进行亚组分析，以进一步探讨异质性。

结果

纳入 50 项研究，共 25289 例 CKD 患者。CI 的总体患病率为 40%（95%置信区间 33-46）。非洲（58%）、亚洲（44%）和美洲（37%）CKD 患者的 CI 患病率相对较高。注意力和执行功能障碍似乎是最常见的表现。血液透析（53%）和腹膜透析（39%）患者的 CI 患病率高于无透析（32%）和肾移植后（26%）患者。此外，年龄较大、合并糖尿病和高血压可能会增加 CKD 患者发生 CI 的风险。