Increased serum methylmalonic acid levels were associated with the presence of cognitive dysfunction in older chronic kidney disease patients with albuminuria

Abstract

Background This study aimed to evaluate the correlation between serum methylmalonic acid (MMA) levels and cognition function in patients with chronic kidney disease (CKD). Methods In this cross-sectional study, we included 537 CKD individuals aged ≥ 60-year-old with albuminuria from the National Health and Nutrition Examination Survey (NHANES) 2011–2014. Four cognitive tests including the Digit Symbol Substitution Test (DSST), the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) Delayed Recall and Word Learning tests, and the Animal Fluency test (AF) were performed. Associations between MMA and cognition scores were assessed with linear regression models. Results MMA level was negatively associated with residual renal function and nutrition status. After multivariate adjustment, elevated serum MMA levels were independently correlated with decline of cognition in CKD patients with albuminuria. Conclusion Our study showed that higher serum MMA levels were independently associated with the presence of cognition dysfunction in CKD patients. The exact pathogenesis of MMA and cognition needs further research.

A commentary on ‘Association between cerebrovascular disease and perioperative neurocognitive disorders: a retrospective cohort study’

“…Lastly, to assess the robustness of associations between CVD and PNDs across various demographics and pinpoint potential population-specific determinants, we recommend conducting subgroup analyses and interaction tests. This should take into account diverse demographic and health-related factors, including gender, age, race, body mass index, diabetes, hyperlipidemia, and smoking status 5 . This approach will enhance our comprehension of variations in environmental impacts among distinct populations.…”