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Association between trace elements and cognitive function among hemodialysis patients in Turkey.

Meric Oruc1, Furkan Asan2, Selda Mercan3

  • 1Nephrology Clinics, Bakırkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey.

Hemodialysis International. International Symposium on Home Hemodialysis
|October 21, 2024
PubMed
Summary

Cognitive impairment is common in hemodialysis patients. Higher blood levels of manganese (Mn) and lead (Pb) are linked to cognitive dysfunction, suggesting trace element accumulation may worsen brain health.

Keywords:
cognitive impairmentexecutive dysfunctionhemodialysistrace elements

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Area of Science:

  • Nephrology
  • Neuroscience
  • Toxicology

Background:

  • Cognitive impairment is a prevalent issue in patients undergoing hemodialysis.
  • Hemodialysis patients face risks of both trace element deficiency and accumulation.
  • The study investigates the link between trace element levels and cognitive function in this population.

Purpose of the Study:

  • To explore the relationship between whole blood trace element levels and cognitive dysfunction in hemodialysis patients.
  • To assess the impact of baseline trace element status and cognitive status on mortality.
  • To identify potential risk factors for cognitive impairment in hemodialysis patients.

Main Methods:

  • Inclusion of maintenance hemodialysis patients and age/sex-matched controls.
  • Measurement of whole blood trace element levels using inductively coupled plasma mass spectrometry.
  • Definition of cognitive impairment (Montreal Cognitive Assessment ≤24) and executive dysfunction (Trails A >75s, Trails B >180s).

Main Results:

  • Cognitive impairment was observed in 69% of hemodialysis patients versus 45.7% of controls.
  • Impaired patients exhibited higher whole blood manganese (Mn) and lead (Pb) levels.
  • Higher Pb levels and lower education were independent risk factors for cognitive impairment.

Conclusions:

  • Cognitive impairment, particularly executive dysfunction, is frequent in hemodialysis patients.
  • Trace element accumulation, specifically Mn and Pb, may contribute to cognitive decline.
  • No association found between cognitive impairment and modifiable ESRD/dialysis factors in this cross-sectional analysis.