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Neurological, psychological, and cognitive disorders in patients with chronic kidney disease on conservative and replacement therapy

机译：保守和替代疗法治疗慢性肾脏病患者的神经，心理和认知障碍

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Chronic kidney disease (CKD) is a highly prevalent condition in the world. Neurological, psychological, and cognitive disorders, related to CKD, could contribute to the morbidity, mortality, and poor quality of life of these patients. The aim of this study was to assess the neurological, psychological, and cognitive imbalance in patients with CKD on conservative and replacement therapy. Seventy-four clinically stable patients affected by CKD on conservative therapy, replacement therapy (hemodialysis (HD), peritoneal dialysis (PD)), or with kidney transplantation (KT) and 25 healthy controls (HC), matched for age and sex were enrolled. Clinical, laboratory, and instrumental examinations, as renal function, inflammation and mineral metabolism indexes, electroencephalogram (EEG), psychological (MMPI-2, Sat P), and cognitive tests (neuropsychological tests, NPZ5) were carried out. The results showed a significant differences in the absolute and relative power of delta band and relative power of theta band of EEG (P?=?0.008, P?P?=?0.051), a positive correlation between relative power of delta band and C-reactive protein (CRP) (P?P?P?P?=?0.016) and theta band (P?=?0.016). Moreover, all NPZ5 scores showed a significant difference between the means of nephropathic patients and the means of the HC, and a positive correlation with eGFR, serum nitrogen, CRP, iPTH, and vitamin D. In CKD patients, simple and noninvasive instruments, as EEG, and cognitive-psychological tests, should be performed and careful and constant monitoring of renal risk factors, probably involved in neuropsychological complications (inflammation, disorders of mineral metabolism, electrolyte disorders, etc.), should be carried out. Early identification and adequate therapy of neuropsychological, and cognitive disorders, might enable a better quality of life and a major compliance with a probable reduction in the healthcare costs.
机译：慢性肾脏病（CKD）是世界上高度流行的疾病。与CKD相关的神经，心理和认知障碍可能会导致这些患者的发病率，死亡率和较差的生活质量。这项研究的目的是评估保守治疗和替代治疗的CKD患者的神经，心理和认知失衡。入选了74例接受CKD保守治疗，替代治疗（血液透析（HD），腹膜透析（PD））或肾移植（KT）和25名健康对照（HC）且年龄和性别相匹配的临床稳定患者。 。进行了临床，实验室和仪器检查，如肾功能，炎症和矿物质代谢指标，脑电图（EEG），心理检查（MMPI-2，Sat P）和认知检查（神经心理检查，NPZ5）。结果表明，脑电图谱中δ带的绝对功率和相对功率与θ带的相对功率存在显着差异（P≥0.008，P≥P≥0.051），δ带的相对功率与C呈正相关。 -反应蛋白（CRP）（P 3 P 2 P 3 P 2 ＝ 0.016）和θ带（P 2 ＝ 0.016）。此外，所有NPZ5评分均显示肾病患者的平均收入与HC的平均收入之间存在显着差异，并且与eGFR，血清氮，CRP，iPTH和维生素D呈正相关。应进行脑电图和认知心理测验，并应持续仔细监测可能与神经心理并发症（炎症，矿物质代谢紊乱，电解质紊乱等）有关的肾脏危险因素。对神经心理学和认知障碍进行早期识别和适当治疗，可能会改善生活质量，并在很大程度上降低医疗费用的情况下达到主要的服从水平。

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