Skip to main content

ORIGINAL RESEARCH article

Front. Aging Neurosci.
Sec. Neurocognitive Aging and Behavior
Volume 16 - 2024 | doi: 10.3389/fnagi.2024.1455596

Elevated HIF-1α Levels in Maintenance Hemodialysis Patients: A Potential Link to Increased Cognitive Impairment Risk

Provisionally accepted
Lan Guo Lan Guo 1Caiyun Jia Caiyun Jia 1Ke Luo Ke Luo 2Juanrong Liang Juanrong Liang 1Lijun Wang Lijun Wang 1Tianli Hui Tianli Hui 3*
  • 1 Hebei General Hospital, Shijiazhuang, Hebei Province, China
  • 2 Tianmen First People's Hospital, Tianmen, Hubei Province, China
  • 3 Hebei Cancer Clinical Medical Research Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China

The final, formatted version of the article will be published soon.

    In China, an increasing number of patients with end-stage renal disease are undergoing hemodialysis treatment. While this treatment yields relatively positive outcomes, the prevalence of cognitive impairment in patients receiving maintenance hemodialysis ranges from 24% to 80%, which is significantly higher than the general population.In this retrospective study, a total of 120 patients with kidney disease undergoing maintenance hemodialysis (MHD) were enrolled. The cognitive status of these patients was assessed using the C-MoCA score, which allowed categorization into two groups: the no cognitive impairment (NCI) group and the cognitive impairment (CI) group. Relevant clinical data, laboratory test results, as well as HIF-1α levels, were collected and analyzed to determine their relationship with the cognitive status of the patients.In this study, a total of 45 patients (37.5%) developed CI, and their C-MoCA scores were significantly lower (21.6±2.43) compared to patients in the NCI group (27.56±1.48) (P<0.001). The CI group was characterized by older age, lower levels of education, as well as lower levels of serum total bilirubin, serum total protein (TP), albumin, serum creatinine, and serum phosphorus in comparison to the NCI group. Additionally, CI patients exhibited higher levels of HIF-1α, received fewer monthly hemodiafiltration or hemoperfusion treatments, and had a lower rate of rosacastat treatment. Furthermore, univariate and multivariate logistic regression analyses demonstrated that older age (OR=11.266 [95% CI: 2.775-45.747], P=0.001) and higher HIF-1α (OR=20.654 [4.831-88.298], P<0.001) increased the risk of developing CI, while higher educational attainment reduced the risk of developing CI (>12 years, OR=0.004 [95% CI: 0.016-0.619], P=<0.001; 6-12 years, OR=0.099 [95% CI: 0.000-0.049], P=0.013).Cognitive impairment in patients undergoing maintenance hemodialysis (MHD) was found to be associated with older age, lower level of education, and higher HIF-1α levels. These factors should be taken into consideration by clinicians to monitor the cognitive status of MHD patients.

    Keywords: HIF-1α, Maintenance hemodialysis, cognitive impairment, biomarker, risk

    Received: 18 Jul 2024; Accepted: 26 Nov 2024.

    Copyright: © 2024 Guo, Jia, Luo, Liang, Wang and Hui. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Tianli Hui, Hebei Cancer Clinical Medical Research Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.