Serum albumin and indoxyl sulfate were predictive of cognitive impairment via amyloid beta and tauopathy, respectively, in end-stage renal disease patients

Abstract Background Patients with ESRD tend to have more risk factors for cognitive impairment than members of the general population, including hypertension, malnutrition, and accumulation of uremic toxin. Blood-based assays with immunomagentic reduction manner have the advantages of being less invasive and more cost-effective for diagnosing patients with cognitive impairment. However, the clinical application for cognitive impairment in patients with ESRD is still lacking. Method In total, 76 participants aged >45 years were enrolled. The definition of ESRD was receiving maintenance hemodialysis for >3 months. Cognitive impairment was defined as a Mini-Mental State Examination score of ≤24. The participants were divided into groups for health control (n=12), ESRD with (n=23)and without cognitive impairment (n=41). The blood-based biomarkers (tau protein, Aβ1/40, Aβ1/42 ) were analyzed through immunomagnetic reduction assay. Other biochemical and hematologic data were obtained simultaneously. Result The study enrolled 76 patients with health control, ESRD who did not have cognitive impairment and ESRD who had cognitive impairment (Mini-Mental State Examination [MMSE]: 30.00± 0.00, 27.60 ± 1.80 vs 18.00 ± 5.09, p < 0.05). The serum albumin was lower in the ESRD with cognitive impairment group (3.70 ± 0.24g/dL, vs 3.89±0.30 g/dL in ESRD without cognitive impairment and 4.40± 0.27g/dL in health control, p