Factors Affecting Cognitive Impairment in Chronic Kidney Disease Patients

Background: Cognitive impairment (CI) is frequently observed in patients with chronic kidney disease (CKD). There are many factors associated with CI in CKD patients in international studies but no study has been done previously in Pakistan on this important issue. Objective: The objective of this study was to determine factors affecting CI in CKD patients Methods: This observational study was carried out in Nephrology Department of Mayo Hospital, Lahore (January 2023 to March 2023). All CKD patients, regardless of cause, were included while patients on renal replacement therapy (RRT) were excluded. The Mini-Mental State Examination (MMSE) tool was employed to evaluate cognitive function. Results: A total of 100 patients were enrolled. The average age of the patients was 50.44±12.58 years, with diabetes mellitus (DM) being the leading cause of CKD in 53(53.0%) patients. CI was identified in 61(61.0%) patients while mild and moderate CI was found in 34 (34%) and 27 (27 %) respectively. Female gender (RR=1.40, 95%CI=1.01-193, p=0.042), low estimated glomerular filtration rate (eGFR) (RR=1.92, 95% CI=1.27-2.91, p=0.002), anemia (RR=1.23, 95% CI=1.01-1.50, p=0.003) and lower educational qualifications (RR= 3.39, 95% CI=1.65-6.94, p=<0.001) were found significant factors of CI. Increasing age was associated with increased CI severity (r=-0.110, p=0.278) while eGFR has positive correlation with CI score (r=0.271,p=0.006) . Conclusion: CI was frequently prevalent among patients with CKD. Female gender, low eGFR, anemia and low level of education were independent predictors of CI in CKD patients. Advancing age has negative correlation while GFR has positive correlation with CI score.