Association between dementia diagnosis at dialysis initiation and mortality in older patients with end-stage kidney disease in South Korea

被引：0

作者：

Ye, Byung Min ^{[1
,2
,21
]}

Kang, Seongmin ^{[3
,21
]}

Park, Woo Yeong ^{[4
,21
]}

Cho, Jang-Hee ^{[5
,21
]}

Yu, Byung Chul ^{[6
,21
]}

Han, Miyeun ^{[7
,21
]}

Song, Sang Heon ^{[8
,21
]}

Ko, Gang-Jee ^{[9
,21
]}

Yang, Jae Won ^{[10
,21
]}

Chung, Sungjin ^{[11
,21
]}

Hong, Yu Ah ^{[12
,21
]}

Hyun, Young Youl ^{[13
,21
]}

Bae, Eunjin ^{[14
,21
]}

Sun, In O. ^{[15
,21
]}

Kim, Hyunsuk ^{[16
,21
]}

Hwang, Won Min ^{[17
,21
]}

Shin, Sung Joon ^{[18
,21
]}

Kwon, Soon Hyo ^{[19
,21
]}

Kim, Seo Rin ^{[1
,2
,21
]}

Yoo, Kyung Don ^{[3
,20
,21
]}

机构：

[1] Pusan Natl Univ, Sch Med, Dept Internal Med, Div Nephrol, Yangsan 50612, South Korea

[2] Pusan Natl Univ, Yangsan Hosp, Res Inst Convergence Biomed Sci & Technol, Yangsan, South Korea

[3] Univ Ulsan, Ulsan Univ Hosp, Coll Med, Dept Internal Med,Div Nephrol, Ulsan 44033, South Korea

[4] Keimyung Univ, Dongsan Hosp, Sch Med, Dept Internal Med,Div Nephrol, Daegu, South Korea

[5] Kyungpook Natl Univ, Kyungpook Natl Univ Hosp, Sch Med, Dept Internal Med,Div Nephrol, Daegu, South Korea

[6] Soonchunhyang Univ, Bucheon Hosp, Dept Internal Med, Div Nephrol, Bucheon, South Korea

[7] Natl Med Ctr, Dept Internal Med, Div Nephrol, Seoul, South Korea

[8] Pusan Natl Univ Hosp, Pusan Natl Univ, Sch Med, Dept Internal Med,Div Nephrol, Pusan, South Korea

[9] Korea Univ, Guro Hosp, Coll Med, Dept Internal Med,Div Nephrol, Seoul, South Korea

[10] Yonsei Univ, Wonju Coll Med, Dept Internal Med, Div Nephrol, Wonju, South Korea

[11] Catholic Univ Korea, Yeouido St Marys Hosp, Coll Med, Dept Internal Med,Div Nephrol, Seoul, South Korea

[12] Catholic Univ Korea, Daejeon St Marys Hosp, Coll Med, Dept Internal Med,Div Nephrol, Seoul, South Korea

[13] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Sch Med, Dept Internal Med,Div Nephrol, Seoul, South Korea

[14] Gyeongsang Natl Univ, Coll Med, Dept Internal Med, Jinju, South Korea

[15] Presbyterian Med Ctr, Dept Internal Med, Div Nephrol, Jeonju, South Korea

[16] Hallym Univ, Coll Med, Dept Internal Med, Dept Internal Med,Div Nephrol, Gyodong, Chuncheon, South Korea

[17] Konyang Univ Hosp, Dept Internal Med, Div Nephrol, Daejeon, South Korea

[18] Dongguk Univ, Sch Med, Ilsan Hosp, Dept Internal Med,Div Nephrol, Goyang, South Korea

[19] Soonchunhyang Univ, Seoul Hosp, Dept Internal Med, Div Nephrol, Seoul, South Korea

[20] Univ Ulsan, Basic Clin Translat Res Ctr, Ulsan, South Korea

[21] Korean Soc Geriatr Nephrol, Seoul, South Korea

来源：

KIDNEY RESEARCH AND CLINICAL PRACTICE | 2025年 / 44卷 / 02期

关键词：

Aged; Chronic kidney failure; Dementia; Mortality; Renal dialysis; COGNITIVE IMPAIRMENT; HEMODIALYSIS-PATIENTS; ALZHEIMERS-DISEASE; RISK; CLASSIFICATION; PREVALENCE; DISORDERS; COHORT;

D O I：

10.23876/j.krcp.23.151

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background: The prevalence of dementia is 2- to 7-fold higher among patients with end-stage kidney disease (ESKD) than among the general population; however, its clinical implications in this population remain unclear. Therefore, this study aimed to determine whether comorbid dementia increases mortality among older patients with ESKD undergoing newly initiated hemodialysis. Methods: We analyzed data from the Korean Society of Geriatric Nephrology retrospective cohort, which included 2,736 older ESKD patients (>= 70 years old) who started hemodialysis between 2010 and 2017. Kaplan-Meier survival and Cox regression analyses were used to examine all-cause mortality between the patients with and without dementia in this cohort. Results: Of the 2,406 included patients, 8.3% had dementia at the initiation of dialysis; these patients were older (79.6 +/- 6.0 years) than patients without dementia (77.7 +/- 5.5 years) and included more women (male:female, 89:111). Pre-ESKD diagnosis of dementia was associated with an increased risk of overall mortality (hazard ratio, 1.503; p < 0.001), and this association remained consistent after multivariate adjustment (hazard ratio, 1.268; p = 0.009). In subgroup analysis, prevalent dementia was associated with mortality following dialysis initiation in female patients, those aged <85 years, those with no history of cerebrovascular accidents or severe behavioral disorders, those not residing in nursing facilities, and those with no or short-term hospitalization. Conclusion: A pre-ESKD diagnosis of dementia is associated with mortality following dialysis initiation in older Korean population. In older patients with ESKD, cognitive assessment at dialysis initiation is necessary.

引用

页码：277 / 287

页数：11

共 26 条

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