Kognitivni poremećaji i demencija kod bolesnika na hemodijalizi
Sažetak
Pacijenti na hemodijalizi su u povećanom riziku od kognitivnog propadanja i razvoja demencije. Sam tok i priroda hronične bubrežne insuficijencije predstavljaju faktore rizika za kognitivno propadanje. Pored toga pacijenti na hemodijalizi su izloženi čestim hemodinamskim stresovima koji utiču na cerebralnu perfuziju na koje su posebno vunerabilni usled čestih komorbiditeta koji nose kardiovaskularni rizik. Takođe kod ove populacije su česte metaboličke abnormalnosti, poremećaji acido-bazne ravnoteže, disbalans vode i elektrolita, pojava inflamacije i oksidativnog stresa i nakupljanje toksičnih materija koji deluju kao faktori rizika za poremećaje kognicije. Adekvatno kognitivno funkcionisanje ovih pacijenata je bitno kako bi oni bili sposobni da vode računa o svom zdravlju i usvajaju medicinske savete, i kako bi imali što bolji kvalitet života. Iz tih razloga veoma je bitna rana detekcija faktora koji dovode do kognitivne disfunkcije kod ove populacije i blagovremena intervencija kako bi se ovi faktori rizika ublažili.
Reference
LITERATURA
Hugo J, Ganguli M. Dementia and Cognitive Impairment: Epidemiology, Diagnosis, and Treatment. Clin Geriatr Med. 2014 Aug 1;30(3):421–42.
Portet F, Ousset PJ, Visser PJ, Frisoni GB, Nobili F, Scheltens P, et al. Mild cognitive impairment (MCI) in medical practice: a critical review of the concept and new diagnostic procedure. Report of the MCI Working Group of the European Consortium on Alzheimer’s Disease. J Neurol Neurosurg Psychiatry. 2006 Jun 1;77(6):714–8.
El, Gohary IE El, Sheshtawi HA, Mohamed MMA. Cognitive disorders in chronic kidney disease and hemodialysis patients. J Egypt Soc Nephrol Transplant. 2018;18(4):130.
Gesualdo GD, Duarte JG, Zazzetta MS, Kusumota L, Say KG, Pavarini SCI, et al. Cognitive impairment of patients with chronic renal disease on hemodialysis and its relationship with sociodemographic and clinical characteristics. Dement Neuropsychol. 2017 Jul 1;11(3):221–6.
Webster AC, Nagler E V., Morton RL, Masson P. Chronic Kidney Disease. Vol. 389, The Lancet. Lancet Publishing Group; 2017. p. 1238–52.
Levey AS, Coresh J. Chronic kidney disease. Vol. 379, The Lancet. Elsevier B.V.; 2012. p. 165–80.
Oh HS, Mo JA, Seo WS. Correlates of cognitive impairment in patients with chronic kidney failure on haemodialysis: Systematic review and meta-analysis. Vol. 75, Journal of Advanced Nursing. Blackwell Publishing Ltd; 2019. p. 962–78.
Hannan M, Phillips SA, Collins EG, Quinn L, Steffen A, Bronas UG. Kidney Disease and Cognitive Impairment in Older Adults: The State of the Science. J Clin Exerc Physiol. 2019 Jun 1;8(2):74–81.
Seliger SL, Siscovick DS, Stehman-Breen CO, Gillen DL, Fitzpatrick A, Bleyer A, et al. Moderate renal impairment and risk of dementia among older adults: The cardiovascular health cognition study. J Am Soc Nephrol. 2004 Jul;15(7):1904–11.
Tian X, Guo X, Xia X, Yu H, Li X, Jiang A, et al. The comparison of cognitive function and risk of dementia in CKD patients under peritoneal dialysis and hemodialysis: A PRISMA-compliant systematic review and meta-analysis. Vol. 98, Medicine (United States). Lippincott Williams and Wilkins; 2019.
Post JB, Morin KG, Sano M, Jegede AB, Langhoff E, Spungen AM. Increased presence of cognitive impairment in hemodialysis patients in the absence of neurological events. Am J Nephrol. 2012 Feb;35(2):120–6.
Pereira AA, Weiner DE, Scott T, Sarnak MJ. Cognitive function in dialysis patients [Internet]. Vol. 45, American Journal of Kidney Diseases. W.B. Saunders; 2005. p. 448–62.
Murray AM, Tupper DE, Knopman DS, Gilbertson DT, Pederson SL, Li S, et al. Cognitive impairment in hemodialysis patients is common. Neurology. 2006 Jul;67(2):216–23.
Marants R, Qirjazi E, Grant CJ, Lee TY, McIntyre CW. Renal perfusion during hemodialysis: Intradialytic blood flow decline and effects of dialysate cooling. J Am Soc Nephrol. 2019 Jun 1;30(6):1086–95.
Burton JO, Jefferies HJ, Selby NM, McIntyre CW. Hemodialysis-induced cardiac injury: Determinants and associated outcomes. Clin J Am Soc Nephrol. 2009 May 1;4(5):914–20.
Mcintyre CW. Recurrent Circulatory Stress: The Dark Side of Dialysis. Vol. 23, Seminars in Dialysis. Semin Dial; 2010. p. 449–51.
McIntyre CW, Burton JO, Selby NM, Leccisotti L, Korsheed S, Baker CSR, et al. Hemodialysis-induced cardiac dysfunction is associated with an acute reduction in global and segmental myocardial blood flow. Clin J Am Soc Nephrol. 2008 Jan;3(1):19–26.
Ibrahim M, Behairy M, El-Ashry M, Mostafa AE. Cardiovascular risk of circulating endotoxin level in prevalent hemodialysis patients. Egypt Hear J. 2018 Mar 1;70(1):27–33.
Kovarova L, Valerianova A, Kmentova T, Lachmanova J, Hladinova Z, Malik J. Low Cerebral Oxygenation Is Associated with Cognitive Impairment in Chronic Hemodialysis Patients. Nephron. 2018 May 1;139(2):113–9.
Wolfgram DF. Intradialytic cerebral hypoperfusion as mechanism for cognitive impairment in patients on hemodialysis. Vol. 30, Journal of the American Society of Nephrology. American Society of Nephrology; 2019. p. 2052–8.
Duranton F, Cohen G, De Smet R, Rodriguez M, Jankowski J, Vanholder R, et al. Normal and pathologic concentrations of uremic toxins. J Am Soc Nephrol. 2012 Jul 1;23(7):1258–70.
Mahoney CA, Arieff AI. Uremic Encephalopathies: Clinical, Biochemical, and Experimental Features. Vol. 2, American Journal of Kidney Diseases. Am J Kidney Dis; 1982. p. 324–36.
Seifter JL, Samuels MA. Uremic encephalopathy and other brain disorders associated with renal failure. Semin Neurol. 2011;31(2):139–43.
O’Lone E, Connors M, Masson P, Wu S, Kelly PJ, Gillespie D, et al. Cognition in people with end-stage kidney disease treated with hemodialysis: A systematic review and meta-analysis. Am J Kidney Dis. 2016 Jun 1;67(6):925–35.
Takeda S, Rakugi H, Morishita R. Roles of vascular risk factors in the pathogenesis of dementia. Vol. 43, Hypertension Research. Springer Nature; 2020. p. 162–7.
Fukunishi I, Kitaoka T, Shirai T, Kino K, Kanematsu E, Sato Y. Psychiatric disorders among patients undergoing hemodialysis therapy. Nephron. 2002;91(2):344–7.
McAdams-Demarco MA, Daubresse M, Bae S, Gross AL, Carlson MC, Segev DL. Dementia, Alzheimer’s disease, and mortality after hemodialysis initiation. Clin J Am Soc Nephrol. 2018 Sep 7;13(9):1339–47.
Assimon MM, Wang L, Flythe JE. Cumulative Exposure to Frequent Intradialytic Hypotension Associates With New-Onset Dementia Among Elderly Hemodialysis Patients. 2019
Huang YC, Kuo YW, Lee TH, Lee M, Hsiao MC, Wang CL, et al. Hypoalbuminemia and Not Hyperhomocysteinemia as a Risk Factor for Dementia in Hemodialysis Patients. J Ren Nutr. 2008 Jul 1;18(4):347–54.
Hugo J, Ganguli M. Dementia and Cognitive Impairment. Epidemiology, Diagnosis, and Treatment. Vol. 30, Clinics in Geriatric Medicine. W.B. Saunders; 2014. p. 421–42.
Shin SJ, Yoon HE, Chung S, Kim YG, Kim DJ. Plasma brain-derived neurotrophic factor in hemodialysis patients. Int J Med Sci. 2012 Oct 24;9(9):772–7.
Zhu B, Jin LN, Shen JQ, Liu JF, Jiang RY, Yang L, et al. Differential expression of serum biomarkers in hemodialysis patients with mild cognitive decline: A prospective single-center cohort study. Sci Rep. 2018 Dec 1;8(1):12250.
Petersen RC. Mild cognitive impairment as a diagnostic entity. In: Journal of Internal Medicine. John Wiley & Sons, Ltd; 2004. p. 183–94.
