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Cognitive Dysfunction in Patients with Chronic Kidney Disease.

H K Aggarwal1, Deepak Jain1, Aswvini Bhavikatti1

  • 1Department of Medicine, Division of Nephrology, Pt. B. D. Sharma University of Health Sciences, Rohtak, Haryana, India.

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Cognitive impairment worsens with advancing chronic kidney disease (CKD) stages. Lower estimated glomerular filtration rate (eGFR) and factors like anemia correlate with poorer cognitive function in CKD patients.

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Area of Science:

  • Nephrology
  • Neurology
  • Geriatrics

Background:

  • Cognitive impairment is prevalent in patients with chronic kidney disease (CKD).
  • This dysfunction significantly contributes to increased patient morbidity.
  • Understanding cognitive decline in CKD is crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate cognitive dysfunction and its severity across different stages of CKD.
  • To identify correlations between cognitive status and various clinical factors.
  • To assess the impact of estimated glomerular filtration rate (eGFR) on cognitive function.

Main Methods:

  • A cross-sectional study involving 100 patients with CKD Stages III-V-D.
  • Cognitive status assessed using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) tests.
  • Patients categorized into four groups based on eGFR, including hemodialysis (HD) patients.

Main Results:

  • A statistically significant decline in both MMSE and MoCA scores was observed with decreasing eGFR and increasing CKD stage.
  • MMSE scores ranged from 28.72 in Group A to 17.28 in Group D; MoCA scores ranged from 26.36 to 20.12.
  • Cognitive scores positively correlated with hemoglobin, corrected calcium, and eGFR; negatively correlated with blood urea, creatinine, uric acid, phosphate, potassium, and CKD stage.

Conclusions:

  • Cognitive dysfunction is progressive and significantly associated with CKD severity.
  • Factors such as anemia and altered mineral metabolism are linked to cognitive decline.
  • Early detection and intervention for cognitive impairment in CKD patients are essential for enhancing quality of life and care compliance.