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学科主题: 临床医学
题名:
Hyponatremia and Cognitive Impairment in Patients Treated with Peritoneal Dialysis
作者: Xu, Rong1,2,3,4; Pi, Hai-chen1,2,3,4; Xiong, Zu-ying5; Liao, Jin-lan5; Hao, Li6; Liu, Gui-ling6; Ren, Ye-ping7; Wang, Qin7; Zheng, Zhao-xia8; Duan, Li-ping8; Dong, Jie1,2,3,4
刊名: CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
发表日期: 2015-10-01
DOI: 10.2215/CJN.02240215
卷: 10, 期:10, 页:1806-1813
收录类别: SCI ; SSCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Urology & Nephrology
研究领域[WOS]: Urology & Nephrology
关键词[WOS]: CHRONIC KIDNEY-DISEASE ; HEMODIALYSIS-PATIENTS ; RISK-FACTORS ; MAINTENANCE HEMODIALYSIS ; MILD HYPONATREMIA ; OLDER PERSONS ; BRAIN ; HYPERNATREMIA ; PREVENTION ; MORTALITY
英文摘要:

Background and objectives Hyponatremia has been identified as a relevant factor for cognitive impairment but has not been investigated in patients receiving peritoneal dialysis (PD). This study investigated the relationship between hyponatremia and cognitive. functions in PD patients.

Design, setting, participants, & measurements A total of 476 clinically stable patients from five PD units who were older than 18 years of age and had undergone PD for at least 3 months between March 2013 and March 2014 were enrolled in this multicenter cross-sectional study. Global cognitive function was measured using the Modified Mini-Mental State Examination (3MS); executive function, by trail making tests A (trails A) and B (trails B); and immediate memory, delayed memory, and language ability, by subtests of Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Hyponatremia was defined as serum sodium level <= 135 mmol/L, which was calculated as the mean of measurements taken over the preceding 3 months.

Results Fifty patients (10.5%) had hyponatremia; these patients tended to be older and less educated, to have less inflammation, and to have the higher prevalence of cognitive impairment. They also had lower scores on RBANS subtests. After adjustment for demographic and clinical confounders, hyponatremia was independently associated with lower 3MS score (coefficient, -5.28; 95% confidence interval [CI], -8.44 to 2.13) and longer completion time of trials A (coefficient, 22.68; 95% CI, 3.44 to 41.92) and B (coefficient, 45.56; 95% CI, 1.30 to 89.81). After additional adjustment for laboratory measures, hyponatremia was still associated with 3MS score and completion time of trails A. Hyponatremia was independently associated with CI (odds ratio, 2.17; 95% CI, 1.02 to 4.94) and executive dysfunction (odds ratio, 2.43; 95% CI, 1.01 to 5.87) using multivariate logistic regression analysis. Sensitivity analyses with multivariable models that included propensity score still supported the association between hyponatremia and cognitive impairment.

Conclusions Hyponatremia was associated with global and specific cognitive impairment in PD patients.

语种: 英语
项目资助者: New Century Excellent Talents from Education Department of China ; ISN Research Award from ISN GO RP Committee
WOS记录号: WOS:000362627600016
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/53907
Appears in Collections:北京大学第一临床医学院_肾脏内科_期刊论文

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作者单位: 1.Minist Educ, Key Lab Renal Dis, Beijing, Peoples R China
2.Peking Univ, Shenzhen Hosp, Div Renal, Shenzhen, Peoples R China
3.Handan Cent Hosp, Div Renal, Handan, Hebei, Peoples R China
4.Peking Univ, Inst Nephrol, Beijing 100034, Peoples R China
5.Minist Hlth, Key Lab Renal Dis, Beijing, Peoples R China
6.Peking Univ, Hosp 1, Div Renal, Dept Med, Beijing 100034, Peoples R China
7.Anhui Med Univ, Hosp 2, Div Renal, Shushan, Anhui, Peoples R China
8.Harbin Med Univ, Affiliated Hosp 2, Div Renal, Harbin, Heilongjiang, Peoples R China

Recommended Citation:
Xu, Rong,Pi, Hai-chen,Xiong, Zu-ying,et al. Hyponatremia and Cognitive Impairment in Patients Treated with Peritoneal Dialysis[J]. CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY,2015,10(10):1806-1813.
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