Settings The Role of Methylglyoxal Accumulation on Cognitive Function Impairment of Chronic Hemodialysis Patients: an Observational Study

Abstract

Background: Cognitive function decline is prevalent on routine hemodialysis patients. Many factors contribute to the increased risk of cognitive function impairment, one of them is the accumulation of uremic toxins. Methylglyoxal (MG) has been identified as one of the uremic toxins found in dialysis patients by the European Uremic Toxin Group. It has also been found much higher on CKD patients; over five times higher in non-dialysis CKD and 18-40 times higher in CKD patients on dialysis, and cause impaired cognitive function in rats with diabetes. Aim: To find the correlation between blood MG levels and cognitive function of patients who underwent routine hemodialysis. Methods: This study is an observational cross-sectional study done in Hemodialysis Unit of Dr. M Djamil General Hospital, Padang, West Sumatera, Indonesia. Fifty-seven subjects aged 40-60 years old were included in this study, where the blood MG levels were obtained. Cognitive function was measured using the Mini Mental State Examination (MMSE) questionnaire. Result: Among 57 subjects, 29 (50.8%) were male, and 33 (57.9%) were 50-60 years old. The subjects’ mean methylglyoxal levels were 10.8 (SD ± 3.2) µmol/L. The subjects’ mean MMSE score was 26 (SD ± 1.8), with 35% of the subjects had low ( < 0.001). Conclusion: High levels of methylglyoxal negatively correlates with cognitive function in chronic hemodialysis patients. Future research should include analysis regarding age, gender, hypertension, and other confounding factors.