title: Prevalence of Cognitive Impairment Among Peritoneal Dialysis Patients, Impact on Peritonitis and Role of Assisted Dialysis.
abstract: ♦
  
  
  
  Chronic renal failure and aging are suggested as risk factors for cognitive impairment (CI). We studied the prevalence of CI among peritoneal dialysis (PD) patients using Montreal Cognitive Assessment (MoCA), its impact on PD-related peritonitis in the first year, and the potential role of assisted PD. ♦
  
  
  
  One hundred fourteen patients were newly started on PD between February 2011 and July 2013. Montreal Cognitive Assessment was performed in the absence of acute illness. Data on patient characteristics including demographics, comorbidities, blood parameters, dialysis adequacy, presence of helpers, medications, and the number PD-related infections were collected. ♦
  
  
  
  The age of studied patients was 59±15.0 years, and 47% were female. The prevalence of CI was 28.9%. Patients older than 65 years old (odds ratio [OR] 4.88, confidence interval [CI] 1.79 - 13.28 p = 0.002) and with an education of primary level or below (OR 4.08, CI 1.30 - 12.81, p = 0.016) were independent risk factors for CI in multivariate analysis. Patients with PD-related peritonitis were significantly older (p < 0.001) and more likely to have CI as defined by MoCA (p = 0.035). After adjustment for age, however, CI was not a significant independent risk factor for PD-related peritonitis among self-care PD patients (OR 2.20, CI 0.65 - 7.44, p = 0.20). When we compared patients with MoCA-defined CI receiving self-care and assisted PD, there were no statistically significant differences between the 2 groups in terms of age, MoCA scores, or comorbidities. There were also no statistically significant differences in 1-year outcome of PD-related peritonitis rates or exit-site infections. ♦
  
  
  
  Cognitive impairment is common among local PD patients. Even with CI, peritonitis rate in self-care PD with adequate training is similar to CI patients on assisted PD.
authors.affiliation: Division of Geriatrics, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: Yat Fung
authors.initials: YF
authors.lastname: Shea
authors.affiliation: Division of Nephrology, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong feimflam@gmail.com.
authors.forename: Man Fai
authors.initials: MF
authors.lastname: Lam
authors.affiliation: Department of Occupation Therapy, Queen Mary Hospital, Hong Kong.
authors.forename: Mi Suen Connie
authors.initials: MS
authors.lastname: Lee
authors.affiliation: Division of Nephrology, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: Ming Yee Maggie
authors.initials: MY
authors.lastname: Mok
authors.affiliation: Division of Nephrology, Department of Medicine, Tung Wah Hospital, Hong Kong.
authors.forename: Sing-Leung
authors.initials: SL
authors.lastname: Lui
authors.affiliation: Division of Nephrology, Department of Medicine, Tung Wah Hospital, Hong Kong.
authors.forename: Terence P S
authors.initials: TP
authors.lastname: Yip
authors.affiliation: Division of Nephrology, Department of Medicine, Tung Wah Hospital, Hong Kong.
authors.forename: Wai Kei
authors.initials: WK
authors.lastname: Lo
authors.affiliation: Division of Geriatrics, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: Leung Wing
authors.initials: LW
authors.lastname: Chu
authors.affiliation: Division of Nephrology, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: Tak-Mao
authors.initials: TM
authors.lastname: Chan
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D060825:Cognitive Dysfunction / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010538:Peritonitis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012648:Self Care
keywords: Cognitive impairment; peritoneal dialysis, peritonitis