Association between Cerebral Oxygenation, as Evaluated with Near-Infrared Spectroscopy, and Cognitive Function in Patients Undergoing Hemodialysis
| Autor: | Keiji Hirai, Hideyuki Hayasaka, Akihisa Watanabe, Keita Horigome, Susumu Ookawara, Takayuki Uchida, Toshiko Aikawa, Hiromi Shimoyama, Yusuke Sasabuchi, Satoru Imada, Yuichiro Ueda, Masaya Kofuji, Hirofumi Shimoyama, Yoshiyuki Morishita, Saori Minato, Kiyonori Ito, Haruhisa Miyazawa |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Cognition Renal Dialysis Internal medicine Diabetes mellitus medicine Vitamin D and neurology Humans Prospective cohort study Aged Oxygen saturation (medicine) Spectroscopy Near-Infrared business.industry Confounding Brain Middle Aged medicine.disease Oxygen Mean blood pressure Cardiology Female Hemoglobin Hemodialysis business |
| Zdroj: | Nephron. 145:171-178 |
| ISSN: | 2235-3186 1660-8151 |
| Popis: | Introduction: The prevalence of cognitive impairment in patients undergoing hemodialysis (HD) is higher than that in healthy controls. To date, studies on the association between cognitive function and cerebral oxygenation in these patients are limited. Therefore, in this study, we aimed to cross-sectionally investigate the association between cognitive assessment scores and clinical factors, including cerebral oxygenation, in patients undergoing HD. Methods: In this observational study, 193 HD patients were included. Cerebral regional oxygen saturation (rSO2) was monitored using an INVOS 5,100c oxygen saturation monitor. Poor cognition was defined as a Mini-Mental State Examination (MMSE) score ≤23. We analyzed the association between MMSE score and clinical factors, including cerebral rSO2. Results: MMSE score in HD patients included in this study was 26.8 ± 3.3. There were 164 patients (85%) with MMSE score ≥24 and 29 patients (15%) with an MMSE score ≤23. In the patients with MMSE score ≥24, cerebral rSO2 (53.8% ± 8.3%) was significantly higher than that in patients with MMSE score ≤23 (49.5% ± 9.8%; p = 0.013). Multivariable linear regression analysis was performed using the following confounding factors: age, mean blood pressure, cerebral rSO2, HD duration, ultrafiltration rate, hemoglobin, serum Cr, serum calcium, serum phosphate, total cholesterol, high-density lipoprotein cholesterol levels, serum albumin, presence of diabetes mellitus or chronic glomerulonephritis, history of comorbid cardiovascular or cerebrovascular disease, and use of renin-angiotensin-aldosterone system inhibitors or vitamin D analogs. MMSE score was independently and significantly associated with age (standardized coefficient: −0.244) and cerebral rSO2 (standardized coefficient: 0.180). Conclusions: MMSE score was independently associated with age (negative effect) and cerebral rSO2 (positive effect) in this cross-sectional study. Further prospective studies are needed to clarify whether maintaining cerebral oxygenation prevents the deterioration of cognitive function in patients undergoing HD. |
| Databáze: | OpenAIRE |
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