Sex-related disparities in cognitive impairment in kidney transplant patients with kidney failure

There are unexplained sex differences regarding prevalence, morbidity, and mortality in chronic kidney disease (CKD). Of note, females are less likely to be waitlisted and experience longer waiting times for kidney transplant (KTx). Recently, interest in cognitive impairment among CKD patients has increased due to its potential negative impact on therapeutic outcomes. This study aimed to investigate the influence of sex on cognitive impairment prevalence and patterns, as well as modifiable dementia risk factors, in KTx recipients.

This cross-sectional study screened KTx recipients for cognitive impairment using the Mini-Addenbrooke's Cognitive Examination. Demographic data, medical histories, and laboratory results were collected from medical records.

The study included 126 consecutive KTx recipients, predominantly male (62%). Males showed higher serum creatinine (1.57 vs. 1.25 mg/dL; p = 0.001), urea (59.50 vs. 55.00 mg/dL; p = 0.046), and uric acid (7.20 vs. 6.20 mg/dL; p = 0.012) levels compared to females. However, creatinine clearance rates did not differ significantly between sexes (49.03 ± 20.29 vs. 50.79 ± 21.7 mL/min/1.73 m²; p = 0.645). A non-significant trend toward higher smoking prevalence among males was observed (p = 0.054). Cognitive impairment prevalence in the overall cohort was 23%, with no significant sex difference (males: 23.1%, females: 22.9%).

There was a high prevalence of cognitive impairment among KTx recipients, affecting both sexes equally. Male predominance in the study cohort likely reflects systemic disparities in transplant access. These findings highlight the importance of integrating sex-specific considerations into the management and follow-up care of KTx recipients.