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Kidney Week

Abstract: TH-PO584

Associations of Bone-Related Markers and Cognitive Function in Hemodialysis Patients

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical


  • Wu, Ping-Hsun, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
  • Lin, Yi-Ting, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
  • Tsai, Jer-Chia, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
  • Kuo, Mei-Chuan, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

Patients undergoing hemodialysis (HD) have a higher risk of cognitive impairment than the general population but limited data elucidated the biomarkers on this. We evaluate the association of bone turnover markers on cognitive function among 251 prevalent HD enrollees in a cross-sectional study.


251 HD patients (median age=57.8; 55% men) without a prior stroke or dementia diagnosis were enrolled. Circulating levels of 8 bone markers (receptor activator of nuclear factor kappa-Β ligand [RANKL], dickkopf-related protein 1 [DKK1], fibroblast growth factor 23 [FGF23], leptin, osteocalcin [OC], Osteopontin [OPN], osteoprotegerin [OPG], sclerostin [SOST]) were analyzed by a multiplex immunobead assay (Millipore, St Charles, MO, US). The association between bone-related markers and cognitive function test (Mini-Mental State Examination [MMSE], Montreal Cognitive Assessment [MoCA], and Cognitive Abilities Screening Instrument [CASI]) were investigated in a linear regression model.


Among 8 bone-related markers, RANKL was the only bone markers found associated with cognitive function (MMSE, MoCA, and CASI test) in HD patients (Figure). In stepwise multiple linear regression analysis, the positive association remained statistically significant in MoCA (β=1.14, 95% CI 0.17 to 2.11) and CASI (β=3.06, 95% CI 0.24 to 5.88). Short-term memory (β=0.52, 95% CI 0.01 to 1.02), mental manipulation (β=0.51, 95% CI 0.05 to 0.96), and abstract thinking (β=0.57, 95% CI 0.06 to 1.09) were significant domain in CASI score.


Serum RANKL levels were found potential associated with higher cognitive function test in HD patients. Further large scale and prospective studies are needed to confirm our findings.


  • Government Support - Non-U.S.