Mutual interaction of clinical factors and specific microRNAs to predict mild cognitive impairment in patients receiving dialysis

Background: To examine mutual interaction of various clinical factors for cognitive impairment in patients receiving dialysis. Methods A total 48 dialysis patients with subjective memory complaints in outpatient clinic were recruited from 2015 to 2017. Demographics, circulating uremic toxin concentrations, miRNA concentrations and nerve injury protein concentrations were collected and measured. Clinical dementia rating (CDR) scores was used to stratify the functional scores of the patients. Receiver operating characteristic(ROC) analysis was used to evaluate diagnostic test performance for predicting dichotomous results, cumulative ROC analysis to examine the combined contribution of clinical factors. Results CDR scale 0 included 15 patients (mean age, 59.1 years; 5 men and 10 women); CDR > 0.5 included 33 patients (mean age, 64.0 years; 18 men and 15 women). On cumulative ROC analysis, the major predictors of mild cognitive impairment were hemoglobin, age, sex, homocysteine, neuron-specific enolase and miR-486. The cumulative AUC on combining hemoglobin, age, and miR-486 was the highest (0.897, 95% confidence interval 0.806–0.988). Two dichotomized variables reached 81.82% sensitivity and 86.67% specificity, with the likelihood ratio for positive and negative results being 6.14 and 0.21, respectively. Conclusion Hemoglobin, age, and miR-486 exerts combined effects on mild cognitive impairment in patients receiving dialysis.