#5133 MONTREAL COGNITIVE ASSESSMENT (MOCA) AND DYSMORPHIC RED BLOOD CELLS IN PATIENTS WITH IMMUNOGLOBULIN A NEPHROPATHY
Bibliographic record
Abstract
Abstract Background and Aims Patients with chronic kidney disease (CKD) are at an increased risk of cognitive dysfunction, which is characterized by deficits in executive functions, memory and attention. Previous studies have suggested that albuminuria and lower estimated glomerular filtration rate (eGFR) are related to mild cognitive impairment (MCI) and dementia. There are no studies that have noticed connection between glomerular activity presented by dysmorphic red blood cells (RBC) count and cognitive evaluation results. The aim of the study was to investigate the association of cognitive decline with renal function and other possible risk factors such as albuminuria, proteinuria, and hematuria in patients with immunoglobulin A nephropathy (IgAN). Method A prospective study that took place from January 2020 till January 2022 at Pauls Stradins Clinical University Hospital Nephrology center included patients with IgAN. Diabetes mellitus, oncology, acute inflammation processes, transplantation in anamnesis were exclusion criteria. Demographic, anamnestic, clinical, laboratory data for renal function evaluation were collected. GFR was calculated using CKD-EPI Creatinine Equation. Urine spot protein/creatine ratio was used for proteinuria measurement. Urine microscopy was performed by a nephrologist. Patients were assessed with a MoCA. Results of MoCA have been compared with potential risk factors. Results Sixty-five patients were included in the study. The mean age of the participants was 42.06 ± 10.71 years (IQR 35-47.75; range, 21-65), with predominance of male sex (62.1%), mainly with higher education (45.5%). Dialysis was performed in 7 patients. The average duration of illness was 89.97 months ± 97.95 (IQR 31.5-120, range 1-456 months/38 years). Average GFR was 59.26 ± 38.66 (IQR 20.25-91.75, range 3-131) ml/min/1,73m2, urea 12.57± 9.88 (IQR 6.3-15.45, range 4-62). Patients did not have anemia, average hemoglobin 135.20± 14.8. Average proteinuria was 0.53±0.99 g/g (IQR 0.064-0.52, range 0.06-6.20), albuminuria - 69.34±107.3 g/mol (IQR 10.95-69.4, range 0.45-620). Average hematuria was 116.68±239.67 RBC/mkl (IQR 9.9-92.1, range 1.5-1421.3), while dysmorphic RBC count was 4.02±12.08 RBC/hpf (IQR 0-2.5, range 0-80). MoCA ≤ 26 was observed in 41% of the patients. The MoCA total score have moderate correlation with the patients age (p = 0.01, r = -0.39). Patients age correlated with memory task score (p = 0.002, r = -0.42). Dysmorphic RBC count in urine sediment corelated with attention task (p = 0.002, r = -0.42). Conclusion Mild cognitive impairment is frequent even in our young age IgAN patient's cohort. Even small age difference plays role in MoCA evaluation score. No correlations have been found between proteinuria or albuminuria and MoCA score. Association between dysmorphic RBC and cognitive decline should be studied in bigger cohorts’ studies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".