实用临床医药杂志2025，Vol.29Issue(11)：1-6,13,7.DOI:10.7619/jcmp.20250446
慢性肾脏病非透析患者认知功能障碍的临床特征及影响因素分析
Clinical characteristics and influencing factors of cognitive impairment in non-dialysis patients with chronic kidney disease
摘要
Abstract
Objective To explore the influencing factors of cognitive impairment in non-dialysis patients with chronic kidney disease(CKD).Methods A total of 60 hospitalized non-dialysis patients with CKD in the Department of Nephrology of Northern Jiangsu People's Hospital Affiliated to Yangzhou University from September 2022 to September 2023 were enrolled as research objects.According to the estimated glomerular filtration rate(eGFR),they were divided into stage 1 to 2 of CKD group[eGFR ≥60 mL/(min·1.73 m2)]with 23 cases,the stage 3 of CKD group[eGFR 30～＜60 mL/(min·1.73 m2)]with 20 cases,and stage 4 to 5 of CKD group[eGFR＜30 mL/(min·1.73 m2)]with 17 cases.The Montreal Cognitive Assessment Scale(MoCA)was used to evaluate the cognitive function of the patients.Basic data and common clinical laboratory in-dicators on hospital admission were collected to analyze the differences in cognitive function levels under different renal function statuses and to explore the influencing factors of cognitive impairment.Results The incidence rates of cognitive impairment in the stage 1 to 2 of CKD group,stage 3 of CKD group,and stage 4 to 5 of CKD group were 47.8％,85.0％,and 94.1％respectively,the median MoCA scored 26,24 and 20 respectively,with statistically significant between-group differ-ences(P＜0.05).Cognitive function was significantly negatively correlated with age(r=-0.634,P＜0.001),blood urea nitrogen(BUN)(r=-0.574,P＜0.001),serum creatinine(Cr)(r=-0.417,P＜0.001),cystatin C(Cys-C)(r=-0.327,P=0.011),serum β2-microglobulin(β2-MG)(r=-0.259,P=0.046),and N-terminal pro-brain natriuretic peptide(NT-proBNP)(r=-0.474,P＜0.001),and was significantly positively correlated with hemoglobin(HB)(r=0.401,P=0.001)and eGFR(r=0.485,P＜0.001).Multivariate Logistic regression analysis showed that age(P=0.006)and NT-proBNP(P=0.041)were influencing factors of cognitive im-pairment in non-dialysis patients with CKD.Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC),sensitivity,and specificity of age for prediction were 0.860,0.864 and 0.812 respectively,the AUC,sensitivity,and specificity of NT-proBNP for pre-diction were 0.808,0.795 and 0.875 respectively,and the combined prediction of age and NT-proBNP had an AUC,sensitivity,and specificity of 0.893,0.955,and 0.750,respectively.Conclusion As renal function deteriorates,the incidence rate and severity of cognitive impairment in non-dialysis patients with CKD tend to increase.Advanced age,renal function deterioration,high NT-proBNP level,and anemia are associated with the occurrence of cognitive impairment in non-di-alysis patients with CKD,among which age and NT-proBNP are influencing factors for cognitive im-pairment.关键词
慢性肾脏病/认知功能障碍/蒙特利尔认知评估量表/估算肾小球滤过率/年龄/N末端脑钠肽前体/贫血/血液透析Key words
chronic kidney disease/cognitive impairment/Montreal Cognitive Assessment Scale/estimated glomerular filtration rate/age/N-terminal pro-brain natriuretic peptide/anemia/hemodialysis分类
医药卫生引用本文复制引用
李红霞,鲁春蕾,朱梦月,牟洪宾,毕光宇,王荣,徐夏,姜洁,贾梦雪,刘文进,韩喆,刘玉双,朱奕蛟,何大锋..慢性肾脏病非透析患者认知功能障碍的临床特征及影响因素分析[J].实用临床医药杂志,2025,29(11):1-6,13,7.基金项目
国家自然科学基金委青年科学基金项目(82302133) （82302133）
江苏省卫生健康委科研项目(Z2022068) （Z2022068）
扬州市科技计划项目(YZ2022169) （YZ2022169）
扬州市科技局科技计划社会发展项目(YZ2022094) （YZ2022094）
苏北人民医院科研项目(SBQN22006) （SBQN22006）
苏北人民医院扶持技术项目(FCJS202340) （FCJS202340）
