Risk factors of cognitive dysfunction in patients taking peritoneal dialysis and establishment of a predictive model
Objective To construct and validate a predictive model for the occurrence of cognitive impairment in patients taking peritoneal dialysis by nomograms.Methods This was a prospective study.One hundred and twenty patients taking peritoneal dialysis at Department of Nephrology,Yantai Laiyang Central Hospital from January 2020 to January 2024 were selected as the study objects.According to the Montreal Cognitive Assessment(MoCA)scores,the patients were divided into a cognitively normal group(52 cases)whose MoCA score ≥26 and a cognitive impairment group(68 cases)whose MoCA score＜26.There were 28 males and 24 females in the cognitively normal group;they were(50.19±12.79)years old.There were 36 males and 32 females in the cognitive impairment group;they were(53.87±10.84)years old.The general data and clinical indicators in both groups were collected.Multivariate logistic regression analysis was used to identify the risk factors of cognitive impairment in the patients.Based on the results,a nomogram prediction model was established and validated by a calibration curve.t and x2 tests were utilized.Results The proportion of the patients with diabetes and the levels of glycosylated hemoglobin(HbA1c),parathyroid hormone(PTH),and serum ferritin(SF)in the cognitively normal group were lower than those in the cognitive impairment group[3.85％(2/52)vs.25.00％(17/68),(5.06±0.31)％vs.(5.52±0.36)％,(304.91±87.79)μg/L vs.(395.69±108.71)μg/L,and(342.83±85.76)μg/L vs.(433.71±134.93)μg/L],with statistical differences(x2=9.895;t=7.359,4.918,and 4.243;all P＜0.05).The multivariate logistic regression analysis showed that having diabetes and high levels of HbA1c,PTH,and SF were independent risk factors for the occurrence of cognitive impairment in the patients(all P＜0.05).Based on these findings,a nomogram prediction model was developed,and it could effectively predict the occurrence of cognitive impairment in the patients.The calibration curve confirmed that the model had good predictive accuracy.Conclusion Patients with diabetes and high HbA1c,PTH,and SF levels have higher risk of cognitive impairment.These factors should be given special attention in treatment,and appropriate preventive measures should be taken.
万方数据
维普
