Study on the Correlation Between Cognitive Impairment and Arteriovenous Fistula Thrombosis in Maintenance Hemodialysis Patients
Objective To explore the relationship between cognitive level and occurrence of arteriovenous fistula thrombosis in maintenance hemodialysis(MHD)patients.Methods A total of 180 patients undergoing MHD in author's hospital from January 2020 to December 2022 were selected.The clinical data,incidence of arteriovenous fistula thrombo-sis and cognitive function score of the MHD patients were investigated.The patients were divided into normal cognitive function group(n=92)and cognitive impairment group(n=88)according to the cognitive scores of the Chinese version of the montreal cognitive assessment-basic(MoCA-B).The correlation between cognitive function scores and the occur-rence of arteriovenous fistula thrombosis of MHD patients was analyzed,the related factors affecting arteriovenous fistula thrombosis were analyzed by Logistic regression analysis.Results The age,the proportion of patients with diabetes mel-litus and the number of arteriovenous fistula thrombosis of MHD patients in the cognitive impairment group were higher than those in the normal cognitive function group,serum albumin was lower than that of the normal cognitive function group,and the difference was statistically significant(all P＜0.05).The incidence of arteriovenous fistula thrombosis in MHD patients with cognitive impairment was significantly higher than that in MHD patients with normal cognitive func-tion(P=0.013).Cognitive impairment assessment scores of MHD patients were negatively correlated with arteriovenous fistula thrombosis(r=-0.175,P=0.019),and negatively correlated with number of impaired domains in cognitive function(r=-0.916,P＜0.001);there was a positive correlation between arteriovenous fistula throm-bosis and number of impaired domains in cognitive func-tion(r=0.189,P=0.011).Logistic multivariate regres-sion analysis showed that MHD patients with normal cognitive function had a lower risk of arteriovenous fistula thrombo-sis than MHD patients with cognitive impairment(OR=0.385,P=0.044),male MHD patients had a lower risk of arte-riovenous fistula thrombosis than female MHD patients(OR=0.363,P=0.039),hemoglobin was an independent risk factor for arteriovenous fistula thrombosis in MHD patients(OR=1.035,P=0.039).Conclusion The incidence of cog-nitive impairment in MHD patients is high,and cognitive impairment will affect the occurrence of arteriovenous fistula thrombosis in patients.The more serious the cognitive impairment,the higher the incidence of arteriovenous fistula thrombosis in patients.Clinical attention should be paid to female MHD patients with cognitive impairment and hyper-hemoglobinemia.At the same time,it is necessary to strengthen the screening of cognitive impairment in MHD patients.Early identification and targeted intervention measures are of guiding significance for reducing the occurrence of arteriove-nous fistula thrombosis and prolonging the service life of fistula in MHD patients.
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