Estimated Glomerular Filtration Rate and Serum Creatinine Level as Predictors of Global Cognition in Elderly with Chronic Kidney Disease and Normal Muscle Mass

AbstractBackground: Chronic kidney disease (CKD) and cognitive impairment are important and prevalent public health problems that lead to increase the risk of morbidity and mortality. Both are considered a major social and financial burden.Cognitive impairment commonly occurs in individuals with CKD; therefore cognitive assessment is extremely important. Early diagnosis and intervention help to decrease the progression of cognitive impairment.Aim: To identify the relation between serum creatinine level and estimated glomerular filtration rate (e-GFR) and global cognitive function (Mini Mental State Examination (MMSE) score in Egyptian elderly with CKD stages 2-4 with normal muscle mass.Methods: Cross-sectional study was conducted at the Geriatrics in-patient wards and outpatient clinics at Ain Shams University Hospitals, Cairo, Egypt, over six months. Fourty five elderly patients who had CKD stages 2-4 with normal muscle mass index were included in the study. Muscle mass was assessed using Bio Electrical Impedance analysis (BIA). History was taken from all participants followed by assessment of the global cognitive function by MMSE, measurement of the serum creatinine level and e-GFR by 24 hours urinary creatinine clearance.Results: There was a significant negative correlation between serum creatinine level and MMSE score, and a significant positive correlation between e-GFR and MMSE score. By regression analysis of possible confounding factors, only e-GFR not serum creatinine level shows a significant correlation with MMSE. Conclusion: e-GFR not serum creatinine level is associated with a lower MMSE score in elderly despite having normal muscle mass.