Predictors of cognitive impairment and its association with mortality in maintenance hemodialysis patients: A prospective follow-up study.

Objective: To determine predictors of cognitive impairment (CI) and its association with mortality in maintenance haemodialysis (MHD) patients.

Methods: This prospective follow up study was conducted at HD Department, Mayo Hospital, Lahore from September, 2021 to November, 2022. All patients undergoing MHD for more than three months and having age between 18-65 years were included while those with dialysis duration less than three months, history of neuropsychiatric illness was excluded. Cognitive function was assessed using British Columbia Cognitive Complaints Inventory (BC-CCI) questionnaire. CI was defined on Likert scale as mild, moderate, and severe. Patients were followed up to one year regarding outcome measures.

Results: One hundred and four patients were included in the study. Mean age was 45.86±11.11 years and Diabetes Mellitus (DM) was the most common cause of End Stage Renal Disease (ESRD) in 39(37.5%) patients. CI was found in 86(82.7%) patients in following order of severity: mild 61(58.7%), moderate 19(18.3%) and severe 6(5.9%). Increasing age (≥50 years), gender (female), Diabetes Mellitus (DM), unemployment and education <10 grade were found as significant predictors of CI (<0.05). Significant positive correlations of CI score with age (r=0.338, <0.001) and MHD duration (r=0.211, =0.032) were found. However, the CI was not significantly associated with mortality (p=0.302).

Conclusion: CI was common in MHD patients. Factors affecting CI were increasing age, female gender, DM, unemployment and low education level. CI was not associated with mortality in MHD patients.