Mild cognitive impairment in maintenance hemodialysis patients: a cross-sectional survey and cohort study

Abstract

Introduction

Few studies focused on mild cognitive impairment (MCI) in maintenance hemodialysis (MHD) patients. This study was conducted to survey the prevalence, the potent risk factors of MCI in MHD patients, and further observe the progress of MCI in a period of 6 months.

Methodology

Mini-Mental State Examination, and Montreal Cognitive Assessment were used to assess cognitive condition. MHD patients were enrolled from The First Affiliated Hospital of Nanjing Medical University, who had a stable hemodialysis history for more than 3 months.

Results

Sixty-four MHD patients and 54 general subjects were finally included. The average age of both groups was more than 60 years. The prevalence of MCI in the MHD group was significantly higher than that in general population (60.9% vs 29.6%, P<0.05). Spearman correlation analysis indicated that MCI was related to age, comorbidities, education years, uric acid, serum albumin, and blood pressure. The prevalence and severity of MCI in the MHD group remained unchanged during the 6 months (prevalence: 59.5%–66.6%, MoCA scores: 22.9–22.5).

Conclusion

MHD patients sustain a fairly high prevalence of MCI. Multiple risk factors influence the incidence and progression of MCI in MHD patients. More attention should be paid to this special population.

Keywords:

• dementia
• end stage renal disease
• Montreal Cognitive Assessment
• Mini-Mental State Examination

Acknowledgments

We thank all the staff of the Department of Geriatric Nephrology, The First Affiliated Hospital of Nanjing Medical University, for their cooperation and the anonymous reviewers. This work was supported by the grants from Clinical Medicine Research Special Funds of Chinese Medical Association 15020020590, Jiangsu Provincial Key Discipline of Medicine ZDXKA2016003, Jiangsu Province’s Key Medical Talents Program ZDRCA2016021, Jiangsu Province 333 Project BRA2017409, Jiangsu Province’s Key Medical Young Talents Program QNRC2016592, and Jiangsu Cadres Health Care Research BJ16016.

Author contributions

WHZ conceived and designed the study. JQW guided and advanced the study. SYL, XHP, XLH, and HCY performed the experiments. XHP, SYL, ZZY, and BZ analyzed the experimental data. XHP, SYL, and NPM wrote the manuscript. XHP and WHZ reviewed and edited the manuscript. All authors contributed to data analysis, drafting and revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.