Background. Patients undergoing hemodialysis experience a greater risk of cognitive impairment than the general population, but limited data elucidates the biomarkers on this. We evaluated the association of bone turnover markers on cognitive function among 251 prevalent hemodialysis enrollees in a cross-sectional study. Methods. 251 hemodialysis patients (, 55% men) and 37 control subjects (, 56% men) without a prior stroke or dementia diagnosis were enrolled. Serum concentrations of 8 bone markers were analyzed as the association of cognitive function (Montreal Cognitive Assessment (MoCA) and Cognitive Abilities Screening Instrument (CASI)) using linear regression analysis. Results. A lower cognitive function was noted in hemodialysis patients compared to control subjects. The receptor activator of nuclear factor kappa-B ligand (RANKL) was the only bone marker found to be associated with cognitive function (MoCA and CASI tests) in hemodialysis patients without a prior stroke or dementia diagnosis. In stepwise multiple linear regression analysis, the association remained significant in MoCA (, 95% CI 0.17 to 2.11) and CASI (, 95% CI 0.24 to 5.88). Short-term memory (, 95% CI 0.01 to 1.02), mental manipulation (, 95% CI 0.05 to 0.96), and abstract thinking (, 95% CI 0.06 to 1.09) were the significant subdomains in the CASI score related to RANKL. Conclusions. Serum RANKL levels were potentially associated with better cognitive function in hemodialysis patients. Further large-scale and prospective studies are needed to confirm our findings.

中文翻译：

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血液透析患者骨转换标志物与认知功能的关联。


背景。接受血液透析的患者比一般人群面临更大的认知障碍风险，但有限的数据阐明了这方面的生物标志物。我们在一项横断面研究中评估了 251 名血液透析参与者中骨转换标志物与认知功能的关联。方法。 251 名血液透析患者（ ， 55% 男性）和 37 名对照受试者（ ， 56% 为男性），之前没有中风或痴呆症诊断。使用线性回归分析将 8 种骨标志物的血清浓度分析为认知功能（蒙特利尔认知评估 (MoCA) 和认知能力筛查仪器 (CASI)）的关联。结果。与对照组相比，血液透析患者的认知功能较低。核因子 kappa-B 配体受体激活剂 (RANKL) 是唯一被发现与先前没有中风或痴呆诊断的血液透析患者的认知功能（MoCA 和 CASI 测试）相关的骨标志物。 在逐步多元线性回归分析中，MoCA 中的相关性仍然显着（， 95% CI 0.17 至 2.11) 和 CASI (， 95% CI 0.24 至 5.88）。短期记忆（， 95% CI 0.01 至 1.02)，精神操纵 (， 95% CI 0.05 至 0.96）和抽象思维（， 95% CI 0.06 至 1.09）是 CASI 评分中与 RANKL 相关的重要子域。结论。血清 RANKL 水平可能与血液透析患者更好的认知功能相关。需要进一步的大规模和前瞻性研究来证实我们的发现。