Disfunção cognitiva em doença renal crônica pré-dialítica: uma revisão sistemática
DOI:
https://doi.org/10.34024/rnc.2021.v29.11431Palavras-chave:
disfunção cognitiva, demência, doença renal, insuficiência renal crônicaResumo
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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Copyright (c) 2021 Leopoldo Antônio Pires, Rogério Bumgratz de Paula, Danielle Guedes Andrade Ezequiel, Natalia Maria da Silva Fernandes
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Aceito: 2021-04-19
Publicado: 2021-07-09