Key result
Stage 4 CKD linked to ~6-point lower MoCA scores in patients with AF.
Why the study?
AF and CKD are independent risk factors for cognitive impairment, and their combination promotes cognitive decline through cerebral hypoperfusion and uremic toxin accumulation.
Does concomitant stage 4 chronic kidney disease worsen cognitive function in patients with atrial fibrillation compared to those without chronic kidney disease?
Cross-Sectional (n=110)
Does concomitant stage 4 chronic kidney disease worsen cognitive function in patients with atrial fibrillation compared to those without chronic kidney disease?
Concomitant stage 4 CKD in patients with atrial fibrillation is associated with significantly worse cognitive function across multiple neuropsychological domains, highlighting the need for active cognitive screening in this population.
Answers are grounded in this paper and cite their sources.
Stage 4 CKD was associated with worse cognition in AF; leaves open whether screening or interventions alter outcomes.
Background: in clinical practice, atrial fibrillation (AF) and chronic kidney disease (CKD) are independent risk factors of cognitive impairment (CI). The combination of AF with progressive CKD, due to cerebral hypoperfusion and the accumulation of "uremic" toxins, provides progression of CI. Aim: to assess cognitive functions in patients with AF and stage 4 CKD compared to patients with AF without CKD Materials and Methods: the singlestep parallel group study included 110 patients divided into 2 groups depending on the presence of CKD: Group 1 — 82 patients (median (Me) age 83 [76; 88] years, females — 53.7%) with AF and stage 4 CKD; Group 2 — 28 patients (median age 72 [68; 83] years, females — 46.4%) with AF without concomitant CKD. All the patients underwent cognitive testing using a neuropsychological test battery. Results: the group comparison revealed that non CKD patients had a significantly higher median total MoCA (26 [24.3; 28.0] vs. 20.5 [17; 25], respectively, p<0.001) and MMSE scores (28.5 [26.0; 29.8] vs. 25 [22.3; 27.0], respectively, p<0.001). Patients with concomitant stage 4 CKD named fewer words during immediate recall (p=0.025) and delayed recall (р<0,001), produced fewer literal associations (p=0.011) and categorical associations (p=0.002), and also performed both parts of the Trail Making Test more slowly (Part A — 105 [72.5; 144.5] vs. 65.5 [43.0; 99.5], p=0.013; Part B — 249.5 [210.3; 300.0] vs. 207 [137.0; 293.8], p=0.025). Conclusion: the obtained data indicate an unfavorable effect of concomitant stage 4 CKD on the cognitive function. These findings underscore the need for active CI screening in this category of patients and the development of comprehensive management approaches aimed not only at arrhythmia control and prevention of thromboembolic complications, but also at preserving the cognitive status of patients. KEYWORDS: atrial fibrillation, chronic kidney disease, cognitive function, cognitive impairment, neuropsychological testing. FOR CITATION: Eremina S.S., Ostroumova T.M., Ostroumova O.D., Shikh E.V., Ebzeeva E.Yu., Gaskina A.A., Suglobova E.V. Cognitive function in patients with atrial fibrillation and concomitant stage 4 chronic kidney disease. Russian Medical Inquiry. 2026;10(9):666–674 (in Russ.). DOI: 10.32364/2587-6821-2026-10-9-11
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Eremina et al. (2026) conducted a cross-sectional in Atrial fibrillation with or without concomitant stage 4 chronic kidney disease (n=110). Concomitant stage 4 chronic kidney disease vs. Atrial fibrillation without concomitant chronic kidney disease was evaluated on Cognitive function assessed by total MoCA and MMSE scores (p=<0.001). Concomitant stage 4 CKD in AF patients was associated with lower median MoCA (20.5 vs. 26, p<0.001) and MMSE scores (25 vs. 28.5, p<0.001) compared to AF without CKD.
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