This study clarified the association of protein-bound uremic toxins on cognitive function in HD patients. In our study, in silico data predicted that IS and PCS could penetrate the BBB. The efflux of uremic toxin from the brain depends on BBB organic anion transporter24. However, according to the clinical study, circulating free form IS, but not PCS, was associated with impaired cognitive function. An inverse association was observed between circulating free form IS levels and the scores of MMSE, CASI, and CASI subdomains of long-term memory, mental manipulation, language ability, and spatial construction. In the fully adjusted linear regression model, circulating free form PCS levels were not significantly associated with MMSE or CASI.
Cognitive function impairment was found in HD patients compared with subjects without kidney disease in the present study and previous meta-analysis1….
