Association between trace elements and cognitive function among hemodialysis patients in Turkey

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY Hemodialysis International Pub Date : 2024-10-21 DOI:10.1111/hdi.13188

Meric Oruc, Furkan Asan, Selda Mercan, Sennur Kose, Mehmet Murat Kirpinar, Burc Cagri Poyraz, Sinan Trabulus, Feray Karaali Savrun, Mehmet Riza Altiparmak

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Abstract

Introduction

Cognitive impairment is common among patients with hemodialysis. Hemodialysis patients have theoretical risks for both deficiency and accumulation of trace elements. We aimed to investigate the relationship between cognitive dysfunction and whole blood levels of trace elements in hemodialysis patients. We also aimed to examine the effect of baseline trace element status and cognitive dysfunction on mortality.

Methods

Maintenance hemodialysis patients and age-and sex-matched controls were included. The whole blood levels of trace elements were measured by inductively coupled plasma mass spectrometry. Cognitive impairment was defined as a score of ≤24 points on the Montreal Cognitive Assessment test. Executive dysfunction was also defined as Trails A score of more than 75 s and Trails B score of more than 180 s.

Findings

Forty-two patients and 35 controls were included. Cognitive impairment was detected in 69% of the patients and 45.7% of the controls (p = 0.039). Cognitively impaired patients had lower education years (p = 0.003) and higher whole blood levels of manganese (Mn) and lead (Pb) (p = 0.026, p = 0.019, respectively) compared to patients without cognitive impairment. Mn levels were also found statistically higher in patients with executive dysfunction compared to patients without executive dysfunction (p = 0.005). Lower education years and higher Pb levels were independent risk factors for cognitive impairment in hemodialysis patients (odds ratio [OR] 0.589 [95% confidence interval, CI 0.400–0.866, p = 0.007] and OR 1.047 [95% CI 1.001–1.096, p = 0.047, respectively]).

Discussion

Cognitive impairment, especially impaired executive function, is common among patients with hemodialysis patients. Cognitive impairment is not found to be associated in cross-sectional analysis with several modifiable end-stage renal disease- and dialysis-associated factors. The accumulation of trace elements especially Mn and Pb might exacerbate the cognitive dysfunction in hemodialysis patients.

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土耳其血液透析患者体内微量元素与认知功能之间的关系。

介绍：认知障碍在血液透析患者中很常见。理论上，血液透析患者存在微量元素缺乏和蓄积的风险。我们旨在研究血液透析患者认知功能障碍与全血微量元素水平之间的关系。我们还旨在研究基线微量元素状态和认知功能障碍对死亡率的影响：方法：纳入维持性血液透析患者和年龄与性别匹配的对照组。采用电感耦合等离子体质谱法测量了全血中的微量元素水平。认知障碍的定义是蒙特利尔认知评估测试得分≤24分。执行功能障碍还被定义为 Trails A 评分超过 75 秒，Trails B 评分超过 180 秒：共纳入 42 名患者和 35 名对照组患者。69%的患者和 45.7% 的对照组发现了认知障碍（P = 0.039）。与无认知障碍的患者相比，认知障碍患者受教育年限较低（p = 0.003），全血锰（Mn）和铅（Pb）水平较高（分别为 p = 0.026 和 p = 0.019）。与无执行功能障碍的患者相比，执行功能障碍患者的锰含量在统计学上也更高（p = 0.005）。教育年限较低和铅含量较高是血液透析患者认知障碍的独立风险因素（几率比[OR]分别为0.589[95%置信区间，CI 0.400-0.866，p = 0.007]和OR 1.047 [95% CI 1.001-1.096，p = 0.047]）：讨论：认知障碍，尤其是执行功能受损，在血液透析患者中很常见。在横断面分析中，未发现认知障碍与几种可改变的终末期肾病和透析相关因素有关。微量元素尤其是锰和铅的积累可能会加重血液透析患者的认知功能障碍。

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来源期刊

Hemodialysis International UROLOGY & NEPHROLOGY-

CiteScore

2.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Hemodialysis International was originally an annual publication containing the Proceedings of the International Symposium on Hemodialysis held in conjunction with the Annual Dialysis Conference. Since 2003, Hemodialysis International is published quarterly and contains original papers on clinical and experimental topics related to dialysis in addition to the Annual Dialysis Conference supplement. This journal is a must-have for nephrologists, nurses, and technicians worldwide. Quarterly issues of Hemodialysis International are included with your membership to the International Society for Hemodialysis. The journal contains original articles, review articles, and commentary to keep readers completely updated in the field of hemodialysis. Edited by international and multidisciplinary experts, Hemodialysis International disseminates critical information in the field.

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