Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
BMC Nephrol. 2024 Aug 30;25(1):283. doi: 10.1186/s12882-024-03729-1.
Both cognitive impairment and malnutrition are common in hemodialysis (HD) patients and are associated with increased hospitalization rates, infection, poor clinical outcomes, and mortality. The study investigated the association between cognitive and nutrition status among end-stage kidney disease (ESKD) patients undergoing hemodialysis.
In this cross-sectional study, we enrolled 115 patients with ESKD who underwent regular hemodialysis (HD). Data collection included the use of screening tools for mild cognitive impairment (MCI), specifically Thai Mental State Examination (TMSE) and Montreal Cognitive Assessment (MoCA). In addition, we collected data using nutritional screening tools including Malnutrition Inflammation Score (MIS) and Nutrition Alert Form (NAF). Our primary outcome was to demonstrate whether there was a relationship between TMSE/MoCA and MIS/NAF scores in this population. Secondary outcomes were a prevalence of MCI and malnutrition status in ESKD patients, an association between TMSE and MoCA with other surrogate nutritional markers, and factors affecting MCI in such patients.
A total of 109 patients undergoing HD completed our protocol. Their mean age was 63.42 (± 15.82) years, and 51.38% were male. Mean TMSE and MoCA were 23.98 (± 5.06) points and 18.3 (± 6.40) points, respectively. The prevalence of TMSE ≤ 23 and MoCA ≤ 24 were 39.45% and 83.49%, respectively. TMSE had a statistically significant negative correlation with MIS (R = 0.16, p < 0.001) and NAF. MoCA also negatively correlated with MIS and NAF. The age, total educational year, the status of whether having a caregiver, serum albumin, serum phosphorus level, handgrip strength, and lean mass tissue were correlated with TMSE.
Nutritional parameters, including MIS score, NAF score, serum albumin, lean tissue mass, and lean tissue index, significantly correlate with TMSE and MoCA.
认知障碍和营养不良在血液透析（HD）患者中很常见，与住院率增加、感染、不良临床结局和死亡率升高有关。本研究旨在调查终末期肾病（ESKD）血液透析患者的认知和营养状况之间的关系。
在这项横断面研究中，我们纳入了 115 名接受常规血液透析（HD）的 ESKD 患者。数据收集包括使用轻度认知障碍（MCI）筛查工具，即泰国精神状态检查（TMSE）和蒙特利尔认知评估（MoCA）。此外，我们还使用营养筛查工具收集了数据，包括营养不良-炎症评分（MIS）和营养预警表（NAF）。我们的主要结果是证明该人群中 TMSE/MoCA 与 MIS/NAF 评分之间是否存在关系。次要结果是 ESKD 患者 MCI 和营养不良的患病率、TMSE 和 MoCA 与其他替代营养标志物之间的关系，以及影响此类患者 MCI 的因素。
共有 109 名接受 HD 的患者完成了我们的方案。他们的平均年龄为 63.42（±15.82）岁，51.38%为男性。TMSE 和 MoCA 的平均得分分别为 23.98（±5.06）分和 18.3（±6.40）分。TMSE≤23 和 MoCA≤24 的患病率分别为 39.45%和 83.49%。TMSE 与 MIS（R=0.16，p<0.001）和 NAF 呈显著负相关。MoCA 也与 MIS 和 NAF 呈负相关。年龄、总受教育年限、是否有照顾者、血清白蛋白、血清磷水平、握力和瘦体组织与 TMSE 相关。
营养参数，包括 MIS 评分、NAF 评分、血清白蛋白、瘦体组织量和瘦体组织指数，与 TMSE 和 MoCA 显著相关。
