Cognitive impairment (CI) is not uncommon in dialysis patients. Various factors have been implicated. This study aims to examine mutual interaction of various clinical factors for CI in patients receiving hemodialysis. A total of 48 hemodialysis patients in outpatient clinic were recruited from 2015 to 2017. Demographics, circulating uremic toxin concentrations, miRNA concentrations, and nerve injury protein concentrations were collected. Clinical dementia rating (CDR) scores were used to stratify the functional scores of the patients. Receiver operating characteristic (ROC) analysis was used to evaluate diagnostic test performance for predicting dichotomous results, and cumulative ROC analysis was used to examine the combined contribution of clinical factors. CDR scale 0 included 15 patients (mean age, 59.1 years); CDR > 0.5 included 33 patients (mean age, 64.0 years). On cumulative ROC analysis, the major predictors of mild CI were hemoglobin, age, sex, homocysteine, neuron-specific enolase (NSE), and miR-486. The cumulative area under the curve (AUC) on combining hemoglobin, age, and miR-486 was the highest (0.897, 95% confidence interval 0.806–0.988). Two dichotomized variables reached 81.82% sensitivity and 86.67% specificity, with the likelihood ratio for positive and negative results being 6.14 and 0.21, respectively. In conclusion, hemoglobin, age, and miR-486 display high-degree combined effects on mild CI in patients receiving hemodialysis.

中文翻译：

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临床因素和特定microRNA的相互影响，以预测接受血液透析患者的轻度认知障碍

透析患者的认知障碍（CI）并不少见。已经牵涉到各种因素。这项研究旨在检查接受血液透析的CI患者的各种临床因素之间的相互影响。从2015年至2017年，共招募了48位门诊的血液透析患者。收集了人口统计学，循环尿毒症毒素浓度，miRNA浓度和神经损伤蛋白浓度。临床痴呆评分（CDR）评分用于对患者的功能评分进行分层。接收者操作特征（ROC）分析用于评估诊断测试性能以预测二分结果，累积ROC分析用于检查临床因素的综合影响。CDR量表0包括15位患者（平均年龄，59.1岁）；CDR> 0。5例包括33例患者（平均年龄64.0岁）。在累积的ROC分析中，轻度CI的主要预测指标是血红蛋白，年龄，性别，同型半胱氨酸，神经元特异性烯醇化酶（NSE）和miR-486。结合血红蛋白，年龄和miR-486的曲线下累积面积（AUC）最高（0.897，95％置信区间0.806-0.988）。两个二分变量分别达到81.82％的敏感性和86.67％的特异性，阳性和阴性结果的似然比分别为6.14和0.21。总之，在接受血液透析的患者中，血红蛋白，年龄和miR-486对轻度CI表现出高度的综合作用。结合血红蛋白，年龄和miR-486的曲线下累积面积（AUC）最高（0.897，95％置信区间0.806-0.988）。两个二分变量分别达到81.82％的敏感性和86.67％的特异性，阳性和阴性结果的似然比分别为6.14和0.21。总之，在接受血液透析的患者中，血红蛋白，年龄和miR-486对轻度CI表现出高度的综合作用。结合血红蛋白，年龄和miR-486的曲线下累积面积（AUC）最高（0.897，95％置信区间0.806-0.988）。两个二分变量分别达到81.82％的敏感性和86.67％的特异性，阳性和阴性结果的似然比分别为6.14和0.21。总之，在接受血液透析的患者中，血红蛋白，年龄和miR-486对轻度CI表现出高度的综合作用。