Cerebral oxygenation and body mass index association with cognitive function in chronic kidney disease patients without dialysis: a longitudinal study

Abstract

In chronic kidney disease (CKD) patients, the prevalence of cognitive impairment increases with CKD progression; however, longitudinal changes in cognitive performance remain controversial. Few reports have examined the association of cerebral oxygenation with cognitive function in longitudinal studies. In this study, 68 CKD patients were included. Cerebral regional oxygen saturation (rSO2) was monitored. Cognitive function was evaluated using mini-mental state examination (MMSE) score. Clinical assessments were performed at study initiation and 1 year later. MMSE score was higher at second measurement than at study initiation (p = 0.022). Multivariable linear regression analysis showed that changes in MMSE were independently associated with changes in body mass index (BMI, standardized coefficient: 0.260) and cerebral rSO2 (standardized coefficient: 0.345). This was based on clinical factors with p < 0.05 (changes in BMI, cerebral rSO2, and serum albumin level) and the following confounding factors: changes in estimated glomerular filtration rate, hemoglobin level, proteinuria, salt and energy intake, age, presence of diabetes mellitus, history of comorbid cerebrovascular disease, and use of renin–angiotensin system blocker. Further studies with a larger sample size and longer observational period are needed to clarify whether maintaining BMI and cerebral oxygenation improve or prevent the deterioration of cognitive function.

A nomogram to predict cognitive function impairment in patients with chronic kidney disease: A national cross-sectional survey

“…Furthermore, our results support the findings of most other studies [ 9 , 14 , 31 ] indicating that eGFR is a risk factor for CFI in patients with CKD. Additionally, the incidence of CFI increased with decreasing eGFR, which is consistent with previous findings [ 32 ].…”

“…Moreover, consistent with the findings of earlier research, a BMI of 30 or above was considered a protective factor in preventing the occurrence of CFI in patients with CKD. As the studies shown that, BMI was positively associated with cognitive function in patients with CKD [ 32 ], and the risk of dementia decreased with BMI increased, whereas the risk increased with underweight [ 49 ]. These previous studies, despite some conflicting results, indicate that CFI in patients with CKD is caused by multiple influencing factors that interact and may enhance or weaken certain mechanisms of cognitive impairment.…”

Prevalence of cognitive impairment and its predictors among chronic kidney disease patients: A systematic review and meta-analysis

“…A total of 4773 publications were identified at the three electronic databases in the initial search, and 50 studies [ 12 – 15 , 21 – 65 ] were included according to the selection criteria. Fig 1 represented the flowchart of the selection of studies for our systematic review and meta-analysis.…”