國家衛生研究院 NHRI:Item 3990099045/12465
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/12465


    Title: Protein-bound uremic toxins are associated with cognitive function among patients undergoing maintenance hemodialysis
    Authors: Lin, YT;Wu, PH;Liang, SS;Mubanga, M;Yang, YH;Hsu, YL;Kuo, MC;Hwang, SJ;Kuo, PL
    Contributors: Institute of Population Health Sciences
    Abstract: Patients with chronic kidney disease have a greater risk of cognitive impairment. Cerebral uremic solute accumulation causes uremic encephalopathy; however, the association of protein-bound uremic toxins on cognitive function remains unclear. The present study aimed to investigate the association of two protein-bound uremic toxins, namely indoxyl sulfate (IS) and p-cresyl sulfate (PCS), on cognitive function in patients receiving hemodialysis (HD) for at least 90 days. Circulating free form IS and PCS were quantified by liquid chromatography/mass spectrometry. Mini-Mental State Examination (MMSE) and Cognitive Abilities Screening Instrument (CASI) were used to evaluate cognitive function. In total, 260 HD patients were recruited with a mean age of 58.1 +/- 11.3 years, of which, 53.8% were men, 40% had diabetes, and 75.4% had hypertension. The analysis revealed that both free IS and free PCS were negatively associated with the CASI score and MMSE. After controlling for confounders, circulating free IS levels persisted to be negatively associated with MMSE scores [beta = -0.62, 95% confidence interval (CI): -1.16 to -0.08] and CASI scores (beta = -1.97, 95% CI: -3.78 to -0.16), mainly in the CASI domains of long-term memory, mental manipulation, language ability, and spatial construction. However, there was no correlation between free PCS and total MMSE or total CASI scores after controlling for confounders. In conclusion, circulating free form IS, but not PCS is associated with lower cognitive function test scores in HD patients. Thus, a further study is needed to evaluate whether a decrease in free IS levels can slow down cognitive decline in HD patients.
    Date: 2019-12-31
    Relation: Scientific Reports. 2019 Dec 31;9:Article number 20388.
    Link to: http://dx.doi.org/10.1038/s41598-019-57004-7
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=2045-2322&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000508985300009
    Cited Times(Scopus): https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85077179563
    Appears in Collections:[Others] Periodical Articles

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