老年慢性肾病与认知功能障碍发生风险关系的Meta分析

摘要

Objective:To systematically evaluate the correlation between chronic kidney disease ( CKD) and the incidence risk of cognitive impairment.Methods: Computer-based retrieval such as Pubmed /Medline, EMBASE and The Cochrane Library ( Issue 5,2013) was used for collecting prospective cohort study relevant to CKD and cognitive impairment from database establishment to May,2013.Two reviewers independ-ently screened studies according to the inclusion and exclusion criteria, extracted data and assessed the quality of included studies.Meta-analysis was conducted using RevMan5.2 software.Results:A total of 4 prospective cohort studies was enrolled, 32059 elderly patients in community in-volved.Meta-analysis results showed that the incidence risk of cognitive impairment for elderly people increased sharply in CKD group , compared with non-CKD group (OR =1.28,95 %CI(1.06 -1.55),P =0.01) .As estimated glomerular filtration rate (eGFR) decreases, the inci-dence risk of cognitive impairment was higher, eGFR 45-60ml/min.1.73m2 group [OR =1.27,95 %CI(1.03 -1.57),P =0.02] ,eGFR<45ml/min.1.73m2 group [OR =1.53,95 %CI(1.73 -3.72),P <0.00 001] , respectively.Conclusion:CKD is an independent risk factor in the incidence of cognitive impairment.%目的：系统评价慢性肾病（Chronic kidney disease，CKD）与认知功能障碍发生风险的相关性。方法：计算机检索 Pubmed／MEDLINE、EMBASE和Cochrane Library数据库，查找与CKD 和认知功能障碍相关的前瞻性队列研究，检索时限均为从数据库建立至2013年5月，由2名研究者按照纳入与排除标准独立筛选文献、提取资料、进行质量评价后，采用 RevMan 5．2软件进行 Meta 分析。结果：最终纳入4个前瞻性队列研究，合计31659例社区老年患者；Meta分析结果显示与非CKD组比较，CKD组老年人发生认知障碍风险明显增加[OR ＝1．28，95％ CI（1．06－1．55），P ＝0．01]，并随估算的肾小球滤过率（Estimated glomerular filtration rate，eGFR）下降，发生认知障碍风险越高，eGFR 45～60 mL／（min・1．73m2）组[OR ＝1．27，95％CI（1．03－1．57），（P ＝0．02）]，eGFR＜45 mL／（min・1．73m2）组OR ＝1．53，95％CI（1．73－3．72）（ P ＜0．00001）。结论：CKD是认知障碍发生的独立危险因素。