Prevalence and risk factors of cognitive disorders in patients on maintenance hemodialysis

BACKGROUND: Cognitive impairment is common but poorly studied in patients with chronic kidney disease, particularly with end-stage renal disease.

AIM: Study to assess the prevalence clinical and demographic risk factors for cognitive impairment in patients receiving maintenance hemodialysis.

METHODS: A cross-sectional, multicenter study was completed with 260 patients aged 18 to 80 years receiving hemodialysis for six months and more. Cognitive functions were using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMCE) scales. Participants were divided into two groups: with cognitive impairment and with normal cognitive function. The relationship between cognitive impairment with clinical and demographic parameters was studied using intergroup comparisons and multivariate logistic regression analysis.

RESULTS: The prevalence of cognitive impairment according to the MoCA scale was 63,5%, according to the MMCE scale – 60,1%. The most common changes were delayed in memory, visual-constructive and executive skills, orientation, attention, and speech. Age, diabetes mellitus, higher systolic blood pressure, elevated C-reactive protein and parathyroid hormone levels were identified as significant independent predictors of cognitive impairment (MoCA<26 points) in patients on maintenance hemodialysis.

CONCLUSION: The obtained results confirm the high prevalence of multimodal cognitive disorders in patients on maintenance dialysis and substantiate the need for regular cognitive screening. Early detection of cognitive impairment and correction of modifiable risk factors can help preserve cognitive function, improve quality of life and prognosis in these patients.