Cognitive Impairment in Patients with Chronic Kidney Disease; A Study from Egypt

Abstract

Background: Patients with chronic kidney disease (CKD) often have cognitive impairment, an issue that is frequently overlooked.

Objective: To determine the prevalence and patterns of cognitive impairment among CKD patients and to evaluate its association with demographic and clinical factors in a tertiary care setting of Egypt.

Methodology: A descriptive cross-sectional study was conducted at the Department of Nephrology, Alexandria University, El-Shatby, Alexandria, Egypt, from January to December 2023. The study included 384 adult patients with CKD in all stages (I–V).  Individuals taking neuropsychiatric drugs and those with underlying neurological or psychiatric conditions were not included.  The Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive function.  Age, gender, educational attainment, stage of chronic kidney disease, comorbidities (diabetes, hypertension), and length of sickness were among the demographic and clinical information gathered.  SPSS v26 was used for data analysis.  Chi-square was used to evaluate for associations between study variables and cognitive impairment, with p < 0.05 being regarded as statistically significant.

Results: Out of 384 CKD patients, 198 (51.56%) had cognitive impairment: 128 (33.33%) mild, 58 (15.10%) moderate, and 12 (3.13%) severe. Cognitive impairment was significantly associated with older age, advanced CKD stage, and comorbidities. Among patients aged >60, 117 (80.69%) had impairment, compared to only 4 (9.52%) in the 18–30 age group (p < 0.001). Impairment was present in 87 (78.38%) patients in CKD stage V vs. 11 (15.49%) in stages I–II (p < 0.001). It was also more common among those with hypertension (174/294, 59.18%, p = 0.002), diabetes mellitus (124/204, 60.78%, p < 0.001), and longer disease duration (>3 years: 116/192, 60.42%, p = 0.032).

Conclusion: Cognitive impairment is prevalent in CKD patients and strongly associated with age, disease severity, and comorbidities, highlighting the need for routine cognitive screening in nephrology care.