| Objective: Analysis of serum Klotho protein FGF23 protein Phosphorus calcium vitamin D3(Vit D3)intact parathyroid hormone(iPTH)Serum creatinine(Scr),blood urea nitrogen(BUN)and other laboratory biochemical indicators in patients with Chronic Kidney Disease The correlation between STAGE 5 CKD undialysed patients and cognitive impairment(CI)provides theoretical basis for early diagnosis and treatment of STAGE 5CKD undialysed CI patients.Methods : Subjects who met the inclusion criteria in outpatient physical examination of Affiliated Hospital of Youjiang Medical College for Nationalities were selected and their cognitive function was measured by The Chinese version of Montreal Cognitive Assessment Scale(MoCA).Subjects with scores ≥26 were healthy control group(group A,n=33).A total of 97 hospitalized CKD5 patients without dialysis who met the diagnostic criteria in the Department of Nephrology,Affiliated Hospital of Youjiang Medical College for Nationalities were selected.Cognitive function was measured by MoCA Chinese version.Patients with score ≥26 were divided into CKD5 without dialysis and without CI group(group B,n=30),and patients with score <26 were divided into CKD5 without dialysis and CI group(group C,n=67).General information of the three groups were recorded,including sex,age,years of education,BODY mass index(BOLY mass index),smoking and alcohol consumption.Serum Klotho protein,FGF23 protein,P,Ca,Vit D3,iPTH,Scr,BUN and other blood biochemical indexes of all subjects were determined.Glomerular filtration rate(GFR)was calculated,the above data of the 3 groups were statistically analyzed,and the differences between the general data and various test indexes of the 3 groups were analyzed.Spearson correlation was used to analyze the correlation between MoCA score and various indexes.Logistic regression was used to analyze the influencing factors of cognitive impairment,and ROC curve was used to evaluate the predictive value of Kloth,FGF23 and Klotho-FGF23 to CI was evaluated by ROC curve.Results :(1)Among the 97 CKD stage 5 patients without dialysis,67 cases(69%)developed CI,and 30 cases(31%)did not(2)The length of education in the CKD5 group without dialysis and without CI was longer than that in the CKD5 group without dialysis and CI,and the age in the CKD5 group without dialysis and CI was longer than that in the healthy control group,the differences were statistically significant(P<0.05).There were no significant differences in smoking and drinking among BMI ethnic groups(P>0.05).(3)FGF23 protein P iPTH TG UA Cysc Scr BUN in CKD5 stage group without dialysis and without CI was lower than that in CKD5 stage group without dialysis and without CI,Klotho protein Hb in CKD5 stage group without dialysis and without CI MoCA score was higher than CKD5 without dialysis and CI group,the difference was statistically significant(P<0.05).ALB TC HDL-C LDL-C VLDL-C β 2-Mg CRP WBC RBC PLT K+ Na+ Cl-in CKD5 without dialysis without CI group and CKD5 without dialysis with CI group had no statistical significance(P<0.05).(4)Logistic regression analysis showed that serum FGF23 protein Scr TG was a risk factor for CI in CKD5 patients without dialysis(P<0.05).(5)SPearson analysis showed that Moca score was negatively correlated with FGF23 protein iPTH TG TC PLT Scr BUN β2-Mg,and positively correlated with Klotho protein Vit D3 Hb ALB(P<0.05).(6)The predictive value of ROC curve for predicting CI in patients without dialysis at stage 5 of CKD,the area of serum Kloth PROTEIN FGF23 and Kloth-FGF23 under the receiver operating curve was 0.877 0.863 0.876(P<0.05).Conclusion :(1)THE prevalence of CI in stage 5 CKD patients without dialysis was high.(2)Serum FGF23 protein,Scr and TG are risk factors for CI in CKD stage 5 patients without dialysis.(3)Serum Kloth protein and FGF23 protein had high value in predicting CI in patients without dialysis at stage 5 of CKD,and were expected to become new predictive indicators. |
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