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Prevalence of CMMSE defined cognitive impairment among peritoneal dialysis patients and its impact on peritonitis

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Abstract

Background

Peritoneal dialysis (PD) exchange procedure is complex. Patients with cognitive impairment (CI) may require assistance. We studied the prevalence of CI among PD patients, its impact on PD-related peritonitis and the outcome of assisted PD.

Methods

Cantonese version of Mini-Mental State examination (CMMSE) was performed in 151 patients newly started on PD. Data on patient characteristics including demographics, co-morbidities, blood parameters, medications, and number of PD-related peritonitis in the first 6 months were collected.

Results

151 subjects were recruited. The age of studied patients was 60 ± 15.0 years, and 45 % were female. The prevalence of CI was 13.9 % using education-adjusted cut-off of CMMSE. Patients older than 65-year-old, female, and lower education level were independent risk factors for CI (OR 9.27 p = 0.001, OR 14.84 p = 0.005, and OR 6.10 p = 0.009, respectively). Age greater than 65-year old is an independent risk factor for PD-related peritonitis but CI was not. Patients requiring assisted PD were of older age (p < 0.001), lower CMMSE (p < 0.001), and scored higher for age-adjusted Charlson Co-morbidity index (p < 0.001). Compared with self-care PD patients, assisted PD patients did not have higher rates exit site infection (p = 0.30) but had a trend of higher PD peritonitis (p = 0.07).

Conclusion

CI is common among local PD patients. Overall, CI could not be identified as an independent risk factor for PD peritonitis. There is a higher prevalence of CI among assisted PD patients but helpers may not completely eliminate the risk of PD-related peritonitis.

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Acknowledgments

The authors would like to acknowledge the Queen Mary Hospital Charitable Trust– Training and Research Assistance Scheme (TRAS)– Grant for supporting this study and the helps from renal nurses of two dialysis centers.

Conflict of interest

The authors have declared that no conflict of interest exists.

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Authors and Affiliations

  1. Division of Geriatrics, Department of Medicine LKS Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong 102 Pokfulam Road, Hong Kong SAR, China

    Yat Fung Shea & Leung Wing Chu

  2. Division of Nephrology, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China

    Man-Fai Lam, Ming Yee Maggie Mok & Tak-Mao Chan

  3. Department of Occupation Therapy, Queen Mary Hospital, Hong Kong, China

    Mi Suen Connie Lee

  4. Division of Nephrology, Department of Medicine, Tung Wah Hospital, Hong Kong, China

    Sing-leung Lui, Terence PS Yip & Wai Kei Lo

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  1. Yat Fung Shea
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  2. Man-Fai Lam
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  9. Tak-Mao Chan
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Correspondence to Yat Fung Shea.

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Shea, Y.F., Lam, MF., Lee, M.S.C. et al. Prevalence of CMMSE defined cognitive impairment among peritoneal dialysis patients and its impact on peritonitis. Clin Exp Nephrol 20, 126–133 (2016). https://doi.org/10.1007/s10157-015-1127-x

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  • DOI: https://doi.org/10.1007/s10157-015-1127-x

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