بررسی اختلال عملکرد شناختی و عوامل موثر بر آن در بیماران همودیالیز مزمن

Abstract Background: Cognitive dysfunction is prevalent among patients with chronic kidney diseases but its fundamental mechanisms are largely unknown. This study explores the prevalence of cognitive dysfunction and related factors in a group of hemodialysis patients. Materials and methods: Cross sectional analysis was performed based upon the data acquired from 189 hemodialysis patients from Tehran. Cognitive dysfunction was determined by the scores of Wechsler test (MQ<90: Abnormal) and depression by the scores of Beck test (score≥ 17:depression). Variables including age, sex, education, the cause of chronic kidney disease, accompanying disorders including depression, medication, the duration of dialysis treatment, Alb(<3.5gr/dl), Hb(10-12: optimal) and qualitative CRP were analyzed. Results: The mean age of the patients was 50.4±15.2 and 65.1 % of the patients were male. The prevalence of cognitive dysfunction among the studied cases was 47%. Higher ages, lower education levels, positive qualitative CRP and presence of diabetes mellitus and depression had significant relationships with cognitive dysfunction (P<0.05). The prevalence of cognitive dysfunction was also higher in patients with opium abuse history and those taking tricyclic antidepressants or those with severe head trauma or stroke history. However, the results were not statically significant. The duration of hemodialysis did not have a significant relationship with the prevalence of cognitive dysfunction. Conclusion: It is possible to defer the development of cognitive dysfunction in CKD patients by increasing their level of education, and also by proper diagnosis and control of diabetes, inflammatory conditions and depression.