血清与血液透析患者中轻度认知障碍的U形关联:一个多中心研究
Yuqi Yang1, Yanjun Long1, Jing Yuan1
1Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China.
Renal failure
|July 10, 2023
概括
血清含量显示出在血液透析患者中与轻度认知障碍 (MCI) 的U形关联. 保持最佳水平 (1.12-1.24 mmol/L) 对于降低这一群体中MCI风险至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 神经学 神经学
- 临床化学 临床化学
背景情况:
- 认知障碍是接受血液透析 (HD) 的患者的一个重大问题.
- 精确的血清含量与HD患者的认知功能相关,仍未确定.
- 这项研究调查了HD患者血清和轻度认知障碍 (MCI) 之间的联系.
研究的目的:
- 确定血清水平与血液透析患者中轻度认知障碍 (MCI) 的发生率之间的关联.
- 为了确定一个最佳的血清的范围,以减少MCI风险在HD群体.
主要方法:
- 一项多中心观察性研究,涉及来自中国贵州省22个中心的3562名血液透析患者.
- 根据血清五分位数,患者被分为五组.
- 使用迷你精神状态检查评估认知功能,MCI是主要结果,通过多变量逻辑回归,受限制的立方线和子组分析进行分析.
主要成果:
- 在HD患者中,MCI的患病率为27.2%.
- 在血清水平和事件MCI (P为非线性 = 0.004) 之间观察到U形关联.
- 与最低MCI风险相关的最佳血清范围为1.12-1.24 mmol/L. 在这个范围之外的水平,无论是较低还是较高,都会增加MCI风险.
结论:
- 血清水平与血液透析患者的轻度认知障碍有U形的关系.
- 血清度低于最佳 (低于1.12 mmol/L) 和过高 (高于1.24 mmol/L) 都会增加患MCI的风险.
- 准血清含量范围为1.12-1.24 mmol/L可能有利于缓解HD患者的认知衰退.
相关概念视频
01:24Chronic Kidney Disease II: Clinical Manifestations
35
Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
35
01:24Serum Studies: Renal Function Tests
23
Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.
23
01:24Hemodialysis II: Procedure and Complications
42
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
42
01:28Chronic Kidney Disease III: Interprofessional Care
43
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
43
01:25Hemodialysis III: Nursing Management
50
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
50
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
36
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
36