Prospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Feb 19, 2024; 14(2): 308-314
Published online Feb 19, 2024. doi: 10.5498/wjp.v14.i2.308
Risk factors for cognitive impairment in patients with chronic kidney disease
Xiao-Hui Wang, Yong He, Huan Zhou, Ting Xiao, Ran Du, Xin Zhang
Xiao-Hui Wang, Yong He, Huan Zhou, Ting Xiao, Xin Zhang, Department of Nephrology, The Fifth Hospital of Wuhan, Wuhan 430050, Hubei Province, China
Ran Du, Department of Nephrology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi 445000, Hubei Province, China
Co-first authors: Xiao-Hui Wang and Ran Du.
Author contributions: Wang XH, Zhang X, and Du R contributed equally to this work; Wang XH, He Y, Zhou H, Xiao T, Du R, and Zhang X designed the research study, and performed the research; Wang XH and Zhang X contributed new reagents and analytic tools; Wang XH, Zhou H, and Zhang X analyzed the data and wrote the manuscript; and all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Fifth Hospital of Wuhan Institutional Review Board.
Clinical trial registration statement: The study was registered at the Clinical Trial Center ( with registration number (researchregistry10159).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Xin Zhang, MMed, Associate Chief Physician, Department of Nephrology, The Fifth Hospital of Wuhan, No. 122 Xianzheng Street, Hanyang District, Wuhan 430050, Hubei Province, China.
Received: October 30, 2023
Peer-review started: October 30, 2023
First decision: November 8, 2023
Revised: December 1, 2023
Accepted: January 5, 2024
Article in press: January 5, 2024
Published online: February 19, 2024
Research background

Chronic kidney disease (CKD) patients have been found to be at risk of concurrent cognitive dysfunction in previous studies, which has now become an important public health issue of widespread concern.

Research motivation

Studies have shown that cognitive impairment in CKD patients may be caused by different dialysis methods and glomerular filtration rates.

Research objectives

This object of this study is to explore the risk factors for cognitive impairment in patients with CKD.

Research methods

We conducted the prospective cohort study between October 2021 and March 2023 in renal internal medicine. A questionnaire was formulated by the method of literature and expert consultation. The questionnaire included questions about age, sex, education level, per capita monthly household income, marital status, living condition, payment method, and hypertension.

Research results

Two hundred patients with CKD undergoing peritoneal dialysis at the hospital were included in this study. Logistic regression analysis showed that patients with CKD undergoing peritoneal dialysis aged 60-79 years [odds ratio (OR) = 1.561, P = 0.015] and ≥ 80 years (OR = 1.760, P = 0.013) had a higher risk of cognitive impairment. Participants with middle and high school education (OR = 0.820, P = 0.027) had a higher risk of cognitive impairment. However, the risk of cognitive impairment was lower for those with a college degree or more (OR = 0.435, P = 0.034) than for those with primary school education or less. The risk of cognitive impairment was lower in married than in unmarried individuals (OR = 0.817, P = 0.046). The risk of cognitive impairment was higher in divorced and widowed individuals than in unmarried individuals (OR = 1.37, P = 0.032). Self-funded patients a higher risk of cognitive impairment (OR = 2.368 P = 0.008). Individuals with hypertension had a higher risk of cognitive impairment (OR = 2.011, P = 0.041).

Research conclusions

The risk factors affecting cognitive dysfunction include age, 60-79 years and ≥ 80 years; education, primary school education or less; marital status, divorced or widowed; payment method, self-funded; hypertension; and CKD, which gradually decreases with continuous peritoneal dialysis.

Research perspectives

Medical staff should assess the cognitive function of patients at the right time and pay regular attention to changes in the patients’ cognitive function.