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

Clin Exp Nephrol. 2016 Feb;20(1):126-33. doi: 10.1007/s10157-015-1127-x. Epub 2015 May 21.

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.

Keywords: Cognitive impairment; Peritoneal dialysis; Peritonitis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Chi-Square Distribution
  • China / epidemiology
  • Cognition Disorders / diagnosis
  • Cognition Disorders / epidemiology*
  • Cognition Disorders / psychology
  • Cognition Disorders / therapy
  • Comorbidity
  • Female
  • Humans
  • Kidney Diseases / diagnosis
  • Kidney Diseases / epidemiology
  • Kidney Diseases / therapy*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Peritoneal Dialysis / adverse effects
  • Peritonitis / diagnosis
  • Peritonitis / epidemiology*
  • Peritonitis / prevention & control
  • Predictive Value of Tests
  • Prevalence
  • Prospective Studies
  • Psychiatric Status Rating Scales*
  • Risk Factors
  • Self Care
  • Treatment Outcome