Disfunção cognitiva em doença renal crônica pré-dialítica: uma revisão sistemática

Autores

DOI:

https://doi.org/10.34024/rnc.2021.v29.11431

Palavras-chave:

disfunção cognitiva, demência, doença renal, insuficiência renal crônica

Resumo

Introdução. No Brasil, a população com mais de 65 anos pode chegar a 25,5%, em 2060. Com o envelhecimento populacional ocorre um aumento da prevalência das doenças degenerativas, dentre as quais o comprometimento cognitivo (CC). Impacto semelhante é observado na doença renal crônica (DRC). Existem fatores fisiopatológicos comuns entre a DRC e o CC. Dentre pacientes com DRC, até 38% apresentam CC. Em relação à fisiopatologia das alterações cognitivas na DRC, os achados são controversos. Objetivo. Avaliar os estudos relacionados à disfunção cognitiva na população com DRC pré-dialítica. Método. Utilizamos as estratégias PRISMA. Selecionamos os unitermos “renal insufficiency, chronic” and “cognitive disfunction”, realizamos a revisão sistemática e não meta-análise dada a disparidade dos estudos. Utilizamos as bases de dados disponíveis de forma gratuita: PubMed, Scielo. A seleção dos artigos foi realizada por dois pesquisadores. Critérios de inclusão: apresentar resumo em língua portuguesa, inglesa, espanhola ou francesa; incluir pacientes em pré-diálise; utilizar avaliações clínicas e/ou laboratoriais e/ou de imagens. Resultados. Encontramos 116 artigos e avaliamos 51. Conclusão. O CC é frequente na DRC e a etiologia permanece em discussão. A maioria dos estudos é derivada de dados secundários de grandes coortes ou estudos transversais. Os instrumentos clínicos mais utilizados são o MEEM e o MoCA e de neuroimagem, a ressonância magnética. Poucos estudos avaliam a inflamação e as toxinas urêmicas. Os mecanismos do CC na DRC são diversos, nem sempre correlacionados, existindo uma grande lacuna no melhor entendimento da associação fisiopatológica destas duas importantes morbidades.

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2021-07-09

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Pires, L. A. ., Bumgratz de Paula, R., Guedes Andrade Ezequiel, D. ., & Fernandes, N. M. da S. (2021). Disfunção cognitiva em doença renal crônica pré-dialítica: uma revisão sistemática. Revista Neurociências, 29. https://doi.org/10.34024/rnc.2021.v29.11431

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Revisão Sistemática
Recebido em 2020-11-24
Aceito em 2021-04-19
Publicado em 2021-07-09

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