Endocrine Abstracts

Backrounds: Prevalence of cognitive function decline in End Stage Renal Disease (ESRD) patients undergoing hemodialysis is higher than in general population. We analyzed risk factors for cognitive function decline in those patients.

Study design: This study included 93 ESRD patients undergoing hemodialysis two or three times a week in Center for hemodialysis, Clinical center of Montenegro and two regional centers for hemodialysis in Montenegro. The cognitive status of patients was assessed using the Mini Mental Score Examination (MMSE) test. Laboratory data about risk factors for cognitive function decline was obtained in Center for clinical-laboratory diagnostic in Clinical center of Montenegro.

Results: All 93 patients have been divided into three groups according the results of MMSE. Patients in first group had severe cognitive impairment and MMSE score below 17 (26.88%), patients in second group with MMSE score 18–23 had moderate cognitive impairment (40.86%) and third group of patients have MMSE >24 and no cognitive impairment (32.26% of patients enrolled in study). There were no significant differences between groups for gender, smoking habits and level of parathyroid hormone. Level of schooling was significantly different between groups of patients (P<0.001). Laboratory markers observed in this study with significant differences between groups were: IGF 1, IGFBP 3, erythrocytes and hemoglobin (P<0.001, P=0.004, P<0.001, P=0.002 respectively). IGF 1 proved to be of great importance for evaluating cognitive status in our study. This marker was statistically different between groups (P<0.001) and Tukey post hoc analysis showed significant differences between all three groups (first and second group P=0.045, second and third group P=0.015, first and third group P<0.001).

Conclusion: Our data suggest that IGF 1 can be considered as novel biomarker for assessment of cognitive functioning in CKD patients what can be of huge clinical importance. This can be important and the particular new significance of this survey in relation to other studies.

Keywords: cognitive status, ESRD, hemodialysis, IGF-1