Association of Arterial Stiffness and Central Pressure With Cognitive Function in Incident Hemodialysis Patients: The PACE Study.

摘要: Introduction Cognitive impairment commonly occurs in hemodialysis patients, with vascular disease potentially implicated its pathogenesis. However, the relationship of detailed assessment cognitive function patients new to has not been demonstrated. Methods In a prospective study incident participants enrolled Predictors Arrhythmic and Cardiovascular Risk ESRD (PACE) study, we determined aortic stiffness by pulse-wave velocity (PWV), systemic arterial augmentation index (AIx) central pulse pressure (cPP), examined their associations processing speed, executive function, global measured Trail making test A (TMTA), B (TMTB), modified Mini-Mental State Exam (3MS). Results Mean baseline age was 55 ± 13 years, 58% were male, 72% African American, 35% had coronary artery disease, 55% diabetes, 10% impairment. At baseline, higher PWV cPP associated longer TMTA, TMTB, but attenuated after multivariable adjustment. 1 year, independently or 3MS. unadjusted adjusted analyses revealed every increase AIx 10 mm Hg TMTB (time difference : 0.14; 95% confidence interval [CI]: 0.02−0.25 log-seconds; time 0.11; CI: 0.05−0.17 log-seconds) (odds ratio [OR] 10.23; 1.77−59.00; OR 2.88; 1.48−5.59). Discussion Higher cPP, which are indicative abnormal wave reflections distal vessels, with, might contribute to, declining starting hemodialysis.