#3040 The association of cognitive dysfunction with markers of oxidative stress and vitamin K deficiency in Chronic Kidney Disease patients
Bibliographic record
Abstract
Abstract Background and Aims During recent years, it became evident that cognitive impairment is highly prevalent in End-Stage Kidney Disease (ESKD), which was mainly attributed to advanced age and vascular calcification (VC). However, the actual prevalence and incidence of cognitive impairment in Chronic Kidney Disease (CKD) are probably underreported. In this study we aimed to investigate the prevalence of cognitive impairment and the possible associations of cognitive function with various traditional and novel VC risk factors in a large cohort of CKD patients. Method We recruited 482 CKD patients of all stages (35 stage I, 29 stage II, 79 stage III, 55 stage 4 and 289 end-stage kidney disease-126 Peritoneal Dialysis-PD and 163 Hemodialysis-HD) and measured plasma levels of the inactive vitamin-K dependent Matrix Gla Protein (dp-ucMGP) (CARIM Institute, Maastricht, Netherlands). In these patients we determined arterial stiffness parameters (pulse wave velocity-PWV) by the Mobil-O-Graph device (IEM, Stolberg, Germany), carotid intime media thickness (cIMT) as a marker of arterial calcification with a B-mode ultrasonography and the presence of plaque in the carotid arteries. We also measured serum malondialdehyde (MDA) a marker of lipid peroxidation in the Department of Biochemistry, Medical School of Nis, Serbia, by ELISA. In our population, we used the MoCA (Montreal Cognitive Assessment) test, a 30-point screening test to detect cognitive impairment in 8 different areas (memory, language, attention and concentration, conceptual thinking, orientation, calculations, executive functions and visuoconstructional skills). Results The mean age of all patients was 65.9 ± 15.4 years and 34% were female. Moca score was correlated with central systolic and diastolic blood pressure (r = 0.15, P = 0.02 and r = 0.28, P < 0.0001), cardiac rhythm (r = 0.12 P = 0.04) creatinine (r = 0.35, P = 0.03), age (r = −0.53, P < 0.0001), duration of hypertension, diabetes mellitus and CVD (r = −0.18, P = 0.001, r = −0.32, P < 0.0001 and r = −0.28 P < 0.0001 respectively), glycated hemoglobin (r = −0.35, P = 0.03), high density lipoprotein cholesterol (r = 0.12, P = 0.003), serum MDA (r = 0.12, P = 0.023) and plasma dp-ucMGP (r = −0.22, P < 0.0001), Spearman's rho test. Kruskal-Wallis analysis showed that Moca score was significantly increased in patients with previous history of CVD (P < 0.0001) and those having a plaque in the carotid artery (P < 0.0001). Moreover, MoCA score decreased progressively with CKD stages (P < 0.0001) Stage Ι 29.2 ± 1.2 Stage II 28.2 ± 2.6 Stage III 26.6 ± 4.3 Stage IV 26.5 ± 3.9 ESKD 26.5 ± 4.3 (HD 26.2 ± 5.3, PD 26.8 ± 3.1). Conclusion Cognitive dysfunction starts early in CKD, is progressively increased with deterioration of kidney function and might be associated with vascular calcification, vitamin K deficiency and increased oxidative stress that are common in this population.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".