The Connection Between Cognitive and Cardiac Function Following Kidney Transplant: The VINTAGE Study
Bibliographic record
Abstract
Rationale & Objective The effects of successful kidney transplant (KT) on cognitive function remain unclear. To clarify how the presence or absence of pre-KT mild cognitive impairment (MCI) affects cognitive changes (overall and domain) after KT. To determine whether the cognitive improvement after KT is associated with improved cardiac function. Study Design A hybrid retrospective and prospective observational cohort study. Setting & Participants We obtained data from 70 recipients who underwent living donor KT (2017-2021). Predictors Pre-KT MCI status and left ventricular (LV) remodeling. Outcomes Changes in mean Montreal cognitive assessment (MoCA) scores before and after KT. Statistical Analysis We evaluated whether the presence or absence of pre-KT MCI modified the effect of KT (total and each domain). We also evaluated the association between changes in MoCA total score and LV reverse remodeling effect. Results MoCA total score: no significant change was observed in the non-MCI group (27.6 ± 1.2 to 27.6 ± 1.6, P = 0.81). In contrast, the score in the MCI group improved from 22.9 ± 2.0 to 24.7 ± 2.0 ( P < 0.001; P int < 0.001). MoCA domain score: the effect of KT varied between the non-MCI group and the MCI group in each domain; the visuospatial and executive domains increased for the MCI group but not non-MCI group ( P int = 0.01). Cognitive and cardiac function: improvement in MoCA score was positively correlated with the effect of LV reverse remodeling ( P = 0.02), even after adjusting for age and tacrolimus trough level. Limitations Incomplete cerebral blood flow data. Conclusions The effect of KT was changed by pre-KT MCI status. Heterogeneous cognitive improvement after KT can be explained by the LV reverse remodeling effect. Plain-Language Summary Kidney transplant can greatly improve health, but how they affect thinking skills wasn't fully understood, especially in people with mild thinking problems before the transplant. We looked at 70 patients. We compared their thinking skills before and after the transplant. We found that for those with normal thinking before, their scores didn't change much. But surprisingly, people with mild thinking problems actually showed improvement in their thinking skills after the transplant. We also saw a link between this improvement in thinking and the heart getting healthier after the transplant. Our study suggests that a successful kidney transplant might help improve thinking in those who had some difficulties beforehand, and this could be related to better heart function.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".