Neurofilament Light Chain and Cognitive Function in Patients Undergoing Hemodialysis: A Cross-Sectional Study

Background: Dementia poses a global challenge for geriatric care and social welfare, including for aging dialysis patients. In recent years, non-invasive blood biomarkers have garnered increasing attention in predicting the development of Alzheimer's disease. Within the general populace, neurofilament light chain (NFL) prognosticates forthcoming cognitive function alongside amyloid-beta (Aβ). Nevertheless, investigation into this matter has yet to be extended to chronic kidney disease patients, including those undergoing hemodialysis. Methods: A cross-sectional study of hemodialysis patients investigated the association between serum Aβ (1-42) and NFL levels with cognitive function as assessed by the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). Results: This study involved 362 patients whose median age was 74 (interquartile range 70-80) years and who had been receiving hemodialysis for a median of 87 (36-168) months. Aβ (1-42) exhibited a median of 2.84 (1.84-4.27) pmol/L, and NFL exhibited a median of 196.2 (146.5-262.2) pg/mL with a non-parametric distribution. The median MoCA and MMSE scores were 25 (22-26) and 28 (26-29). NFL levels transformed by the natural logarithm significantly negatively correlated with cognitive function in a multivariate linear regression analysis, including confounding factors (β coefficient [95% confidence interval], -0.98 [-1.76, -0.2]; P=0.014 for MoCA, and -0.67 [-1.3, -0.05]; P=0.034 for MMSE). No significant associations existed between cognitive function and Aβ (1-42) levels. Conclusion: Low levels of NFL were associated with preserved cognitive function in patients undergoing hemodialysis. Funding: Private Foundation Support