title: Risk factors for cognitive dysfunction in CKD and hypertensive subjects.
abstract: OBJECTIVE
  Cognitive dysfunction (CO/DY) in chronic kidney disease (CKD) patients has long been recognized. Hypertension is also associated with CO/DY. The study describes associated factors with CO/DY in CKD patients compared to hypertensive subjects.
  
  
  METHODS
  Ninety-six hypertensive subjects without CKD, 19 patients with CKD stages I-II, 33 with CKD III, 42 with CKD stage IV, 33 on hemodialysis (HD) and 33 on peritoneal dialysis (PD) were included in our study. Cognitive impairment measured by MMSE, clock-drawing test and IADL was considered as primary outcome.
  
  
  RESULTS
  In all groups tested, age was significantly associated with CO/DY by almost all cognitive function tests. Among CKD patients, CKD stage and DM were significantly associated with CO/DY by all three cognitive function tests. PTH levels were also associated with CO/DY by MMSE and clock-drawing tests. In hypertensives, pulse pressure (PP) was associated with CO/DY by clock-drawing and IADL tests, while those receiving CCBs as monotherapy were less likely to have CO/DY by IADL test. For dialysis patients, DM was significantly related to CO/DY by MMSE and clock-drawing tests. In the same group of patients Hb <11 g/dl was significantly correlated with CO/DY by MMSE, dialysis modality and Kt/V >1.2 by IADL test. PD patients were less likely to present with CO/DY by clock-drawing test.
  
  
  CONCLUSIONS
  In every CKD stage, the risk of CO/DY increased significantly. Low Hb levels (Hb <11 g/dl) and increased serum PTH levels were associated with CO/DY while DM plays also a significant role in cognitive function deterioration. Among hypertensive subjects, those with PP ≤60 mmHg or receiving CCBs showed a better executive function.
authors: Department of Nephrology, University Hospital of Ioannina, Ioannina, Greece.
authors: Rigas G
authors: RG
authors: Kalaitzidis
authors: Despina
authors: D
authors: Karasavvidou
authors: Athina
authors: A
authors: Tatsioni
authors: Olga
authors: O
authors: Balafa
authors: Kosmas
authors: K
authors: Pappas
authors: Giorgos
authors: G
authors: Spanos
authors: Sigkliti-Henrietta
authors: SH
authors: Pelidou
authors: Kostas C
authors: KC
authors: Siamopoulos
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001794:Blood Pressure; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003072:Cognition Disorders / Q000453:epidemiology* / Q000523:psychology; D003920:Diabetes Mellitus / Q000453:epidemiology; D056344:Executive Function; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010281:Parathyroid Hormone / Q000097:blood; D010530:Peritoneal Dialysis; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D002121:Calcium Channel Blockers; D006454:Hemoglobins; D010281:Parathyroid Hormone
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