Cognitive impairment and patient reported outcomes in advanced kidney disease
Notice bibliographique
Résumé
Shared decision making is now an integral part of renal practice. Quality of life is therefore an important consideration, especially for older patients. This thesis provides insight into the influence of dialysis modality on quality of life in older people with advanced kidney disease. It also explores the relationship between cognitive impairment and dialysis. Firstly, quality of life measures were compared between older patients on assisted peritoneal dialysis and haemodialysis. Patients on assisted peritoneal dialysis were matched to haemodialysis patients by baseline characteristics. Quality of life assessments were carried out quarterly for 2 years. Following multivariate analyses, there was no consistent difference in quality of life between patients on haemodialysis and assisted peritoneal dialysis. The second study assesses the influence of dialysis on cognition and patient reported outcome measures in patients with advanced kidney disease. Patients on haemodialysis, peritoneal dialysis or with chronic kidney disease (eGFR < 30ml/min) patients were recruited. Study participants were assessed 4 monthly for up to 2 years. Mixed model analysis showed that cognitive function declined faster in dialysis patients compared with non-dialysis patients with chronic kidney disease. In the dialysis cohort, executive function was better preserved in patients on peritoneal dialysis compared with haemodialysis patients. Dialysis did not consistently influence trends in patient reported outcome measures during follow up. Finally, the relationship between cognition and decision making capacity was explored in a small pilot of renal patients. Cognition and decision making capacity were assessed by the Montreal Cognitive Assessment and Macarthur Competence Assessment tools respectively. Patients with lower cognitive scores tended to have lower capacity assessment scores, albeit without reaching statistical significance. In older patients with advanced kidney disease, risk factors other than dialysis modality, influence quality of life. Cognitive decline, one such risk factor, may accelerate with dialysis depending on modality. It may also affect decision making. These findings highlight the need to screen for geriatric syndromes in older patients with renal disease.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».