Key result
Declining eGFR in CKD is linked to decreased cognitive function on MMSE and MoCA tests.
Why the study?
Cognitive impairment is common in CKD patients and contributes to increased morbidity, but its severity across CKD stages and related factors need evaluation.
Cross-Sectional (n=100)
Cognitive dysfunction worsens progressively with advancing stages of chronic kidney disease, highlighting the need for early assessment and intervention.
Cognitive impairment screening may warrant consideration in advanced CKD; cross-sectional data leaves open causality and intervention effects.
Cognitive impairment is a common entity in patients with chronic kidney disease (CKD), which plays an important role in increasing the morbidity in these patients. This study was performed to evaluate cognitive dysfunction and its severity in different stages of CKD and identify the correlation with factors affecting this dysfunction. A cross-sectional design study was conducted on 100 patients with CKD Stage III to V-D fulfilling the eligibility criteria. Cognitive status was assessed using the mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) tests. The patients were divided into four groups according to their estimated glomerular filtration rate (eGFR); Group A with eGFR ranging between 30 and 59 mL/min/1.73 m2, Group B with eGFR between 15 and 29 mL/min/1.73 m2, Group C with eGFR <15 mL/min/1.73 m2 not on hemodialysis (HD), and Group D with eGFR <15 mL/min/1.73 m2 and on HD for the past six months. Factors affecting MMSE and MoCA scores were assessed using univariate and multivariate linear regression analysis. Mean MMSE score was 28.72 ± 1.37 in Group A, 26.00 ± 3.67 in Group B, 20.76 ± 4.84 in Group C, and 17.28 ± 3.32 in Group D, which showed a statistically significant difference. The mean MoCA score also showed a statistically significant decline from Group A to Group D with values being 26.36 ± 1.91, 24.56 ± 1.94, 22.08 ± 2.12 and 20.12 ± 1.81, respectively (P < 0.05). The MMSE and MoCA scores were found to have a statistically significant positive correlation with hemoglobin; serum corrected calcium and eGFR (P < 0.01) and statistically significant negative correlation with blood urea, serum creatinine, serum uric acid, serum phosphate, serum potassium and stage of CKD (P < 0.01). By raising the clinician’s awareness about cognitive dysfunction in CKD patients and its potential effects on medication, fluid and, dietary compliance improved quality of care is expected. Early intervention will improve the patient’s quality of life.
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Jain et al. (2020) conducted a cross-sectional in Chronic kidney disease (n=100). Declining estimated glomerular filtration rate (eGFR) vs. Higher eGFR (Group A: 30-59 mL/min/1.73 m2) was evaluated on Cognitive status assessed using MMSE and MoCA tests (p=< 0.05). Declining estimated glomerular filtration rate in chronic kidney disease was associated with a statistically significant decrease in cognitive function on MMSE and MoCA tests (P < 0.05).
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