Impact of combined artificial kidney on cognitive dysfunction in patients undergoing maintenance hemodialysis
Objective To explore the impact of combined artificial kidney on cognitive dysfunction in patients undergoing ma-intenance hemodialysis,aiming to provide a reference for clinical treatment.Methods This study selected 90 regular hemo-dialysis patients admitted to the First Affiliated Hospital of Chongqing Medical and Pharmaceutical College from January 2020 to January 2023 as the participants.Patients were randomly assigned to a control group(n=45)and an observation group(n=45)using the random number table method.The control group received hemodialysis(HD)twice a week plus hemodiafiltration(HDF)once a week;the observation group received HD twice a week,HDF once a week,and HD plus hemoperfusion(HP)once a month.The levels of creatinine,urea nitrogen,β2-microglobulin,uric acid,parathyroid hor-mone,homocysteine(Hcy),C-reactive protein(CRP),interleukin-6(IL-6),and the scores of the Montreal Cognitive As-sessment(MoCA)and Mini-Mental State Examination(MMSE)were compared before the first dialysis and at 6 months of dialysis between the two groups.Results Before dialysis,no significant difference was observed in creatinine,urea nitro-gen,parathyroid hormone,uric acid,β2-microglobulin,and Hcy levels between the two groups(P＞0.05).At 6 months of dialysis,the levels of creatinine,urea nitrogen,β2-microglobulin,parathyroid hormone,and Hcy in both groups were de-creased significantly compared to before dialysis(P＜0.05).At 6 months,the levels of β2-microglobulin,parathyroid hor-mone,and Hcy in the observation group were all significantly lower than in the control group(P＜0.05).Before dialysis,no significant difference was observed in MOCA and MMSE scores between the two groups(P＞0.05).At 6 months of di-alysis,the MOCA and MMSE scores in both groups were higher than before dialysis,and the observation group's scores were higher than the control group's,with statistically significant differences(P＜0.05).Before dialysis,no statistically significant difference was found in CRP and IL-6 levels between the two groups(P＞0.05).At 6 months of dialysis,the levels of CRP and IL-6 in both groups were significantly lower than before dialysis,and the observation group's levels were significantly lower than the control group's(P＜0.05).Spearman correlation analysis results showed that at 6 months of di-alysis,the patients'MOCA and MMSE scores were not correlated with creatinine,urea nitrogen,and uric acid levels,but were negatively correlated with β2-microglobulin,parathyroid hormone,Hcy,CRP,and IL-6 levels.Conclusion Compared with patients receiving HD combined with HDF treatment,patients receiving HD,HDF combined with HP showed higher cognitive function levels at 6 months of dialysis,which was correlated with their lower levels of parathyroid hormone,β2-mi-croglobulin,and Hcy,as well as inflammatory markers.
Combined artificial kidneyMaintenance hemodialysisCognitive impairmentMontreal cognitive assessmentMini-mental state examination
万方数据
维普
