Cognitive impairment in chronic kidney disease

被引:362
作者
Kurella, M
Chertow, GM
Luan, J
Yaffe, K
机构
[1] Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA
[2] Univ Calif San Francisco, Moffitt Long Hosp, Mt Zion Med Ctr, Dept Med,Div Nephrol, San Francisco, CA 94143 USA
[3] Univ Calif San Francisco, Moffitt Long Hosp, Mt Zion Med Ctr, Dept Med,Div Psychiat, San Francisco, CA 94143 USA
[4] Univ Calif San Francisco, Moffitt Long Hosp, Mt Zion Med Ctr, Dept Med,Div Neurol, San Francisco, CA 94143 USA
[5] Univ Calif San Francisco, Moffitt Long Hosp, Mt Zion Med Ctr, Dept Med,Div Epidemiol, San Francisco, CA 94143 USA
关键词
cognitive impairment; chronic kidney disease; end-stage renal disease; dementia;
D O I
10.1111/j.1532-5415.2004.52508.x
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Objectives: To assess the prevalence of cognitive impairment in persons with chronic kidney disease (CKD) and its relation to the severity of CKD. Design: Cross-sectional study. Setting: University-affiliated ambulatory nephrology and dialysis practices. Participants: Eighty subjects with CKD Stages III and IV not requiring dialysis (CKD) and 80 subjects with CKD Stage V on hemodialysis (end-stage renal disease (ESRD)) with a mean age+/-standard deviation of 62.5+/-14.3. Measurements: Three standardized cognitive tests, the Modified Mini-Mental State Examination (3MS), Trailmaking Test B (Trails B), and California Verbal Learning Trial (CVLT). Glomerular filtration rate was estimated in subjects with CKD using the six-variable Modification of Diet in Renal Disease equation. Results: There was a graded relation between cognitive function and severity of CKD. Mean scores on the 3MS, Trails B, and CVLT immediate and delayed recall were significantly worse for subjects with ESRD than for subjects with CKD or published norms (P<.001 for all comparisons). Scores on the Trails B (P<.001) and CVLT immediate (P=.01) and delayed (P<.001) recall were significantly worse for subjects with CKD not requiring dialysis than for published norms. In addition, the fraction of subjects with impairment on the 3MS and Trails B increased with decreasing kidney function. Conclusion: Cognitive impairment is associated with the severity of kidney disease. Further studies are needed to determine the reasons for cognitive impairment in subjects with CKD and ESRD.
引用
收藏
页码:1863 / 1869
页数:7
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