372 Cross-sectional association between serum magnesium with cognition in patients undergoing hemodialysis: the Osaka Dialysis Complication Study

• Published in: Nephrology, dialysis, transplantation Vol. 39; no. Supplement_1
• Main Authors: Shoji, Tetsuo, Mori, Katsuhito, Nakatani, Shinya, Morioka, Tomoaki, Fujii, Hisaka, Emoto, Masanori
• Format: Journal Article
• Language: English
• Published: 23.05.2024
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfae069.874

Abstract Background and Aims Impaired cognitive performance is common in patients with chronic kidney disease including those undergoing haemodialysis, although the mechanisms are not well understood by which chronic kidney disease affects cognitive function. Phosphate plays an important role in the development of aging phenotypes particularly in patients with chronic kidney disease. Phosphate toxicity is thought to be mediated by calciprotein particles, and a shorter T50 reflects a higher propensity of transformation of primary to secondary calciprotein particles. T50 is known to be affected by phosphate, fetuin-A, magnesium, and others. We examined possible relationship between cognitive function and CKD-MBD-related factors in patients undergoing haemodialysis. Method This was a cross-sectional study in 1207 patients on maintenance haemodialysis selected from the participants of Osaka Dialysis Complication Study (ODCS). Cognitive function was assessed by Modified Mini-Mental State examination (3MS). Associations of serum calcium, phosphate, intact PTH, magnesium, fetuin-A, and T50 with 3MS was examined by multiple regression models adjusted for age, sex, dialysis vintage, diabetic kidney disease, prior stroke, prior non-stroke cardiovascular disease, education level, SBP, DBP, Hb, BMI, serum albumin, and CRP. Results Serum magnesium and phosphate levels were significantly and positively associated with 3MS level independent of the potential confounders, whereas other factors were not. Conclusion We found positive associations of cognitive performance with serum magnesium and phosphate levels in haemodialysis patients, suggesting the roles of CKD-MBD-related factors in impaired cognition in this population.