ABSTRACT
Objective To investigate the correlation between serum levels of homocystein (Hcy),Cystatin C (Cys C)and cognitive impairment in patients with chronic kidney disease (CKD).Methods 78 patients with CKD from January 2016 to May 2017 in Hanzhong People's Hospital in Shaanxi were enrolled for the study and divided into stage 3 groups (n 27),stage 4 group (n=28) and stage 5 group (n =23) according to stage of CKD.Montreal cognitive assessment scale (MoCA) was performed to evaluate the cognitive level of patients,and they were divided into cognitive impairment group and normal group.Serum levels of Hcy,Cys C,creatinine (SCr) and urea nitrogen (BUN) were compared among groups,and the correlation between them and cognitive level was analyzed.Results ①Serum levels of Hcy,Cys C,SCr and BUN in stage 3 group were significantly lower than that in stage 4 and 5 group,and these indexes in stage 4 group were significantly lower than that in stage 5 group (F=19.221～66.539,all P＜0.05).The score of MoCA in stage 3 group was significantly lower than that in stage 5 group,and the incidence of cognitive impairment was significantly higher than that in stage 5 group (F/x2 =3.993～6.358,all P＜0.05).②The serum levels of Hcy,Cys C,SCr and BUN in cognitive impairment group were significantly higher than in normal group (t =2.198 ～ 3.835,all P＜ 0.05).③ Pearson analysis result showed that MoCA score was negatively correlated with serum Hcy,Cys C and SCr (r=-0.370,-0.392,-0.253,P＜0.05),but there was no sig nificant correlation between score and BUN (r=-0.211,P＞0.05).④For prediction of cognitive impairment,area under the receiver operating curve of serum levels of Hcy,Cys C,SCr and BUN were 0.818,0853,0.751 and 0.709 (P＜0.05).Conclusion Serum levels of Hcy,Cys C were significantly negatively correlated with cognitive function in patients with CKD,whose predictive value were higher than that ot traditional renal function indexes such as SCr and BUN.