title: Relationship between uric acid and subtle cognitive dysfunction in chronic kidney disease.
abstract: BACKGROUND
  Elevated serum uric acid has been associated with cognitive dysfunction and vascular cognitive impairment in the elderly. Serum uric acid is also commonly elevated in chronic kidney disease (CKD), but its relationship with cognitive function in these patients has not been addressed.
  
  
  METHODS
  Subjects with CKD (defined as eGFR <60/ml/min/1.73 m(2)) were evaluated for cognitive dysfunction using the validated Standardized Mini-Mental State Examination (SMMSE). Individuals with dementia, depression or other psychiatric disorders were excluded, as were subjects on uric acid-lowering therapy or with serious illnesses such as severe anemia or active or ongoing cardiovascular or cerebrovascular disease.
  
  
  RESULTS
  247 subjects were enrolled. SMMSE scores showed stepwise deterioration with increasing quartile of serum uric acid (26.4; 26.1; 25.5; 25.3, score range 20-30, p = 0.019). Post-hoc analysis demonstrated that there was no linear trend and only groups 1 and 4 were different with respect to SMMSE scores (p = 0.025). Stepwise multivariate linear regression revealed that age, educational status, presence of cerebrovascular disease, and serum uric acid were independently related to SMMSE scores.
  
  
  CONCLUSIONS
  Serum uric acid levels are independently and inversely associated with mild cognitive dysfunction in subjects with CKD.
authors.affiliation: Division of Nephrology, Department of Medicine, Zonguldak State Hospital, Zonguldak, Turkey.
authors.forename: Baris
authors.initials: B
authors.lastname: Afsar
authors.forename: Rengin
authors.initials: R
authors.lastname: Elsurer
authors.forename: Adrian
authors.initials: A
authors.lastname: Covic
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Johnson
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kanbay
mesh_terms: D000367:Age Factors; D000368:Aged; D002561:Cerebrovascular Disorders / Q000150:complications; D003072:Cognition Disorders / Q000097:blood* / Q000150:complications* / Q000523:psychology; D004522:Educational Status; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011581:Psychological Tests; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications* / Q000523:psychology; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid