Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Oct 15;17(11):sfae312.
doi: 10.1093/ckj/sfae312. eCollection 2024 Nov.

Addressing cognitive impairment in peritoneal dialysis: a systematic review and meta-analysis of prevalence, risk factors, and outcomes

Noppawit Aiumtrakul  1 , Charat Thongprayoon  2 , Pitchaporn Yingchoncharoen  3 , Chalothorn Wannaphut  1 , Wannasit Wathanavasin  2   4 , Supawadee Suppadungsuk  2   5 , Pajaree Krisanapan  2   6 , Wisit Cheungpasitporn  2
Affiliations
Review

Addressing cognitive impairment in peritoneal dialysis: a systematic review and meta-analysis of prevalence, risk factors, and outcomes

Noppawit Aiumtrakul et al. Clin Kidney J. .

Abstract

Background: Cognitive impairment (CI) is a critical complication in peritoneal dialysis (PD) patients, associated with decreased quality of life and increased hospitalization. Despite its significant impact, the prevalence, risk factors, and consequences of CI in PD patients are not well understood. We aimed to determine the prevalence, risk factors, and outcomes of CI in PD patients.

Methods: We performed systematic reviews in OVID Medline, Embase, and Cochrane databases until February 2024 to identify cross-sectional and cohort studies on prevalence of CI (identified by cognitive assessment scales) in PD patients. The Newcastle-Ottawa Scale was used to assess risk of bias. A pooled meta-analysis of CI prevalence in PD and a subgroup analysis comparing the risk of CI between PD and non-PD settings were performed using a random-effects model.

Results: A total of 19 studies were identified, involving 2882 PD patients. The pooled prevalence of CI in PD patients was 47.7% (95%CI: 35.8-59.9%). CI in patients undergoing PD appears to be associated with older age, female gender, lower levels of education, and is linked to higher rates of hospitalization and peritonitis, compared to those without CI. However, it is not associated with increased mortality. Compared to hemodialysis, PD showed a trend toward a lower risk of CI (OR 0.64, 95%CI 0.39-1.03; P = .068).

Conclusion: CI is highly prevalent and associated with several adverse clinical outcomes in PD patients. These findings could contribute to facilitate the development of screening and early intervention strategies to reduce the burden of disease in this population.

Keywords: cognitive impairment; dementia; end-stage renal disease; peritoneal dialysis.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Figure 1:
Figure 1:
Flowchart of search methodology.
Figure 2:
Figure 2:
Forest plots of the pooled prevalence of CI in PD patients.
Figure 3:
Figure 3:
Comparison of the risk of CI between PD patients and control groups.
Figure 4:
Figure 4:
Meta-regression between year of publication and prevalence of CI in PD patients.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Thurlow JS, Joshi M, Yan G et al. Global epidemiology of end-stage kidney disease and disparities in kidney replacement therapy. Am J Nephrol 2021;52:98–107. 10.1159/000514550 - DOI - PMC - PubMed
    1. Chuasuwan A, Pooripussarakul S, Thakkinstian A et al. Comparisons of quality of life between patients underwent peritoneal dialysis and hemodialysis: a systematic review and meta-analysis. Health Qual Life Outcomes 2020;18:191. 10.1186/s12955-020-01449-2 - DOI - PMC - PubMed
    1. Gupta R, Woo K, Yi JA. Epidemiology of end-stage kidney disease. Semin Vasc Surg 2021;34:71–78. 10.1053/j.semvascsurg.2021.02.010 - DOI - PMC - PubMed
    1. United States Renal Data System . 2022 USRDS Annual Data Report: Epidemiology of kidney disease in the United States. 2022; National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA.
    1. Li JSC. Prevalence of cognitive impairment among elderly Chinese continuous ambulatory peritoneal dialysis patients. Hong Kong J Nephrol 2004;6:22–30. 10.1016/S1561-5413(09)60122-8 - DOI

LinkOut - more resources