Effects of cognitive impairments on the compliance and quality of life of the patients with continuous ambulatory peritoneal dialysis

Abstract

Objective To investigate the onset of cognitive impairments and its effects on the compliance and the quality of life of the patients with continuous ambulatory peritoneal dialysis (CAPD) . Methods A cross-sectional study was performed in the patients with CAPD who were treated and followed up in the department of Nephrology of Taixing People's Hospital from October 2015 to May 2016. Then the cognitive function of the patients was evaluated by the Montreal Cognitive Assessment (MoCA) .The end stage renal disease adherence questionnaire (ESRD-AQ) was applied to explore the treatment compliance of the patients. The quality of life was investigated by the SF-36 questionnaire. Results A total of 109 cases were enrolled. The proportion of cognitive impairments in the CAPD patients was 67.9% (MoCA score<26) . Compared to the patients in the group with normal cognitive function (MoCA score≥26) , the patients with cognitive impairments were significantly older (χ2=7.901, P=0.019) , with higher dialysis age (χ2=7.211, P=0.025) , longer hypertension history (χ2=4.254, P=0.039) , longer diabetes history (χ2=4.331, P=0.037) , lower education degree (χ2=7.421, P=0.024) and lower urea clearance index (χ2=4.331, P=0.037) .At the same time, the compliance levels of the patients with cognitive impairments was significantly lower compared to the patients with normal cognitive function in the components of diet control (χ2=9.826, P=0.043) , fluid restriction (χ2=11.056, P=0.021) , medication therapeutic regimens (χ2=8.296, P=0.040) and dialysis regimens (χ2=10.680, P=0.030) . The patients with cognitive impairments also showed a significantly lower score in the dimensions of physical function (t=2.564, P=0.013) , general health (t=2.262, P=0.026) , social function (t=2.676, P=0.018) , affection function (t=2.644, P=0.010) and mental health (t=2.196, P=0.031) . Conclusions The morbidity of cognitive impairments in the CAPD patients is higher, which has a serious impact on the compliance and the quality of life of the patients. Key words: Peritoneal dialysis, continuous ambulatory; Compliance of drug treatment; Quality of life; Cognitive impairments