{"title":"肾功能和认知障碍：一项系统综述和荟萃分析。","authors":"Xiaohua Pei, Nazia Begum Bakerally, Zhan Wang, Yun Bo, Yao Ma, Zhenzhu Yong, Sizhu Zhu, Fei Gao, Zhu Bei, Weihong Zhao","doi":"10.1080/0886022X.2025.2463565","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>A worldwide evaluation exploring the link between a broad-spectrum kidney function and cognitive impairment (CI) prevalence, and related risk factors has yet to be conducted.</p><p><strong>Methods: </strong>Studies published before November 2024 were retrieved from PubMed and Web of Science. R software (R Foundation for Statistical Computing, Vienna, Austria) and Review Manager (Cochrane Collaboration, London, UK) were used to analyze the relationship of CI with various estimated glomerular filtration rate (eGFR) level and the associated risk factors. A random model effect was adopted for a heterogeneity (<i>I</i><sup>2</sup>) of more than 50%.</p><p><strong>Results: </strong>Seventeen (involving 32,141 participants) out of 5892 studies were included. The MMSE and MoCA were the most commonly used tests to assess cognitive function. The prevalence of CI raised significantly with declining kidney function: 10% for eGFR ≥60 mL/min/1.73 m<sup>2</sup>, 47.3% for 60-30 mL/min/1.73 m<sup>2</sup>, and 60.6% for <30 mL/min/1.73 m<sup>2</sup>, totaling 16.7% overall. Thirteen potential risk factors were ascertained and analyzed. In the forest-plot analysis, T2DM, cardiovascular diseases, cerebrovascular diseases, and lower education emerged as strong predictors of risk, with odds ratios of 1.55, 1.63, 1.95, and 2.59, respectively. A mean meta-analysis of the continuous variable indicators revealed that advanced age and elevated parathyroid hormone (PTH) levels were statistically significant in the occurrence of CI.</p><p><strong>Conclusions: </strong>The poorer the renal function, the higher the prevalence rate of CI. Patients with chronic kidney disease (CKD) have multiple risk factors that lead to CI.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2463565"},"PeriodicalIF":3.0000,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881663/pdf/","citationCount":"0","resultStr":"{\"title\":\"Kidney function and cognitive impairment: a systematic review and meta-analysis.\",\"authors\":\"Xiaohua Pei, Nazia Begum Bakerally, Zhan Wang, Yun Bo, Yao Ma, Zhenzhu Yong, Sizhu Zhu, Fei Gao, Zhu Bei, Weihong Zhao\",\"doi\":\"10.1080/0886022X.2025.2463565\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>A worldwide evaluation exploring the link between a broad-spectrum kidney function and cognitive impairment (CI) prevalence, and related risk factors has yet to be conducted.</p><p><strong>Methods: </strong>Studies published before November 2024 were retrieved from PubMed and Web of Science. R software (R Foundation for Statistical Computing, Vienna, Austria) and Review Manager (Cochrane Collaboration, London, UK) were used to analyze the relationship of CI with various estimated glomerular filtration rate (eGFR) level and the associated risk factors. A random model effect was adopted for a heterogeneity (<i>I</i><sup>2</sup>) of more than 50%.</p><p><strong>Results: </strong>Seventeen (involving 32,141 participants) out of 5892 studies were included. The MMSE and MoCA were the most commonly used tests to assess cognitive function. The prevalence of CI raised significantly with declining kidney function: 10% for eGFR ≥60 mL/min/1.73 m<sup>2</sup>, 47.3% for 60-30 mL/min/1.73 m<sup>2</sup>, and 60.6% for <30 mL/min/1.73 m<sup>2</sup>, totaling 16.7% overall. Thirteen potential risk factors were ascertained and analyzed. In the forest-plot analysis, T2DM, cardiovascular diseases, cerebrovascular diseases, and lower education emerged as strong predictors of risk, with odds ratios of 1.55, 1.63, 1.95, and 2.59, respectively. A mean meta-analysis of the continuous variable indicators revealed that advanced age and elevated parathyroid hormone (PTH) levels were statistically significant in the occurrence of CI.</p><p><strong>Conclusions: </strong>The poorer the renal function, the higher the prevalence rate of CI. Patients with chronic kidney disease (CKD) have multiple risk factors that lead to CI.</p>\",\"PeriodicalId\":20839,\"journal\":{\"name\":\"Renal Failure\",\"volume\":\"47 1\",\"pages\":\"2463565\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881663/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Renal Failure\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/0886022X.2025.2463565\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/3/4 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Renal Failure","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/0886022X.2025.2463565","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/4 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：一项探讨广谱肾功能与认知功能障碍（CI）患病率及相关危险因素之间关系的全球评估尚未开展。方法：从PubMed和Web of Science检索2024年11月前发表的研究。使用R软件（R Foundation for Statistical Computing, Vienna, Austria）和Review Manager （Cochrane Collaboration, London， UK）分析CI与各种估算肾小球滤过率（glomerular filtration rate, eGFR）水平及相关危险因素的关系。当异质性（I2）大于50%时，采用随机模型效应。结果：在5892项研究中纳入17项（涉及32,141名参与者）。MMSE和MoCA是评估认知功能最常用的测试。随着肾功能下降，CI患病率显著升高：eGFR≥60 mL/min/1.73 m2组为10%，60-30 mL/min/1.73 m2组为47.3%，2组为60.6%，合计16.7%。确定并分析了13个潜在的危险因素。在森林样地分析中，T2DM、心血管疾病、脑血管疾病和低教育程度是风险的强预测因子，比值比分别为1.55、1.63、1.95和2.59。对连续变量指标的平均荟萃分析显示，高龄和甲状旁腺激素（PTH）水平升高与CI的发生有统计学意义。结论：肾功能越差，CI患病率越高。慢性肾脏疾病（CKD）患者有多种导致CI的危险因素。
Kidney function and cognitive impairment: a systematic review and meta-analysis.
Background: A worldwide evaluation exploring the link between a broad-spectrum kidney function and cognitive impairment (CI) prevalence, and related risk factors has yet to be conducted.
Methods: Studies published before November 2024 were retrieved from PubMed and Web of Science. R software (R Foundation for Statistical Computing, Vienna, Austria) and Review Manager (Cochrane Collaboration, London, UK) were used to analyze the relationship of CI with various estimated glomerular filtration rate (eGFR) level and the associated risk factors. A random model effect was adopted for a heterogeneity (I2) of more than 50%.
Results: Seventeen (involving 32,141 participants) out of 5892 studies were included. The MMSE and MoCA were the most commonly used tests to assess cognitive function. The prevalence of CI raised significantly with declining kidney function: 10% for eGFR ≥60 mL/min/1.73 m2, 47.3% for 60-30 mL/min/1.73 m2, and 60.6% for <30 mL/min/1.73 m2, totaling 16.7% overall. Thirteen potential risk factors were ascertained and analyzed. In the forest-plot analysis, T2DM, cardiovascular diseases, cerebrovascular diseases, and lower education emerged as strong predictors of risk, with odds ratios of 1.55, 1.63, 1.95, and 2.59, respectively. A mean meta-analysis of the continuous variable indicators revealed that advanced age and elevated parathyroid hormone (PTH) levels were statistically significant in the occurrence of CI.
Conclusions: The poorer the renal function, the higher the prevalence rate of CI. Patients with chronic kidney disease (CKD) have multiple risk factors that lead to CI.
期刊介绍：
Renal Failure primarily concentrates on acute renal injury and its consequence, but also addresses advances in the fields of chronic renal failure, hypertension, and renal transplantation. Bringing together both clinical and experimental aspects of renal failure, this publication presents timely, practical information on pathology and pathophysiology of acute renal failure; nephrotoxicity of drugs and other substances; prevention, treatment, and therapy of renal failure; renal failure in association with transplantation, hypertension, and diabetes mellitus.
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