慢性病的严重程度和认知障碍的风险
Zhijie Huang1,2, Kristine Yaffe3,4,5, Changwei Li6
1Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
JAMA network open
|February 17, 2026
概括
慢性病 (CKD) 的严重程度与认知能力下降有关. 尿中蛋白质与肌素比率 (UPCR) 的较高和估计的淋巴细胞过率 (eGFR) 的较低增加了注意力,处理速度和执行功能障碍的风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 神经学 神经学
- 流行病学 流行病学
背景情况:
- 慢性病 (CKD) 严重程度和偶发性认知障碍之间的关联尚未得到充分证实.
- 评估诸如EGFR和UPCR之类的CKD严重性标志物对于理解认知能力下降风险至关重要.
研究的目的:
- 研究CKD严重程度 (eGFR和UPCR) 与CKD患者认知障碍发生率之间的关联.
- 为了确定预测认知衰退的特定CKD标志物.
主要方法:
- 在CRIC研究中对5607名CKD患者进行的队列研究 (2003-2008,2013-2015年).
- 使用全球认知测试评估认知功能,口头记忆,注意力,处理速度和执行功能.
- 使用考克斯比例危险回归来分析基线eGFR,UPCR和认知障碍的时间之间的关联.
主要成果:
- 较高的UPCR与注意力/处理速度 (HR 1.21) 和执行功能 (HR 1.16) 损害的风险增加有关.
- 较低的eGFR与注意力/处理速度受损的风险增加有关 (HR 1.21).
- 低EGFR (<60毫升/分钟/1.73米2) 和高UPCR (≥150毫克/克) 组合显著增加了全球认知障碍风险 (HR 1.38).
结论:
- 根据eGFR和UPCR指出的CKD严重程度是发生认知障碍的重要危险因素.
- 这些发现凸显了管理CKD的重要性,以潜在地减轻认知能力下降.
- 在对患者的综合护理中,应考虑CKD的严重程度,以防止认知障碍.
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