Association Between Chronic Kidney Disease and Neurological Manifestations: A Cross-Sectional Study of Cognitive Impairment, Peripheral Neuropathy, and Cerebrovascular Risk

Abstract

Background: To assess the link between the severity of chronic kidney disease (CKD) and neurological changes, such as cognitive impairment, peripheral neuropathy, and cerebrovascular risk factors. Materials and methods: This was a cross-sectional analytical study conducted in a hospital setting with 209 adult CKD patients. Data on demographics, clinical, laboratory, and renal function were obtained. The Montreal Cognitive Assessment was used to measure cognitive function, and peripheral neuropathy was evaluated by a standardized neurological examination. The chi-square/Fisher's exact test, independent-samples t-test and Mann–Whitney U test were used to assess associations. Independent predictors were determined by multivariable logistic regression. Results: Cognitive impairment was present in 91 (43.5%) participants and peripheral neuropathy in 83 (39.7%). The prevalence of both conditions rose with the CKD stage (p<0.001). Older age, lower education, diabetes, hypertension, cardiac disease, previous cerebrovascular disease, lower eGFR, and dialysis dependence were associated with cognitive impairment. Longer duration of CKD, diabetes, lower eGFR, anemia, and dialysis dependence were associated with peripheral neuropathy. There was a positive correlation between MoCA score and eGFR (r=0.41, p<0.001). Adjusting for these factors, eGFR <30 mL/min/1.73 m² and dependence on dialysis were independently associated with both neurological outcomes. Conclusions: Neurological symptoms were common in CKD and were more prevalent as renal function declined. Regular neurological/cognitive evaluations should be considered, especially in advanced CKD and dialysis-dependent patients