Abstract: Objective  To analyze the risk factors of cognitive impairment (CI) in patients with end-stage renal disease and receiving different dialysis methods.  Methods  A total of 93 patients on maintenance hemodialysis (MHD) and 50 patients on peritoneal dialysis (PD) treated in the First Affiliated Hospital of Bengbu Medical College from November 2021 to April 2022 were recruited as the research subjects. According to the scores of Montreal cognitive assessment, the patients were divided into CI group of MHD patients, non-CI group of MHD patients, CI group of PD patients, and non-CI group of PD patients. CI and related risk factors was analyzed between the groups.  Results  A total of 143 patients were enrolled in this study, 70 (48.95%) were males, and the mean age was 52.25±11.37 years old. A total of 75 patients had CI, with a prevalence rate of 52.45%. Multivariate logistic regression showed that age, platelet/lymphocyte ratio (PLR), cystatin C, and homocysteine (Hcy) were the independent risk factors for CI in MHD patients (OR=1.080, 1.017, 1.749 and 1.167 respectively; 95% CI：1.001～1.166, 1.003～1.030, 1.205～2.541 and 1.003～1.358 respectively; P=0.047, 0.013, 0.003 and 0.046 respectively); while age, hemoglobin, PLR, and 25-hydroxy-vitamin-D were the independent risk factors for CI in PD patients (OR=1.253, 0.907, 1.027 and 0.696 respectively; 95% CI：1.042～1.507, 0.830～0.992, 1.001～1.054 and 0.491～0.989 respectively; P= 0.016, 0.032, 0.044 and 0.043 respectively). Receiver operating characteristic curve analysis showed that age, PLR and the model of the combined two had better predictive values for CI in MHD and PD patients, and the combined model had the highest predictive value (for MHD patients: AUC=0.714, 0.723 and 0.798 respectively; 95% CI：0.611～0.817, 0.620～0.826 and 0.711～0.886 respectively; P＜0.001; for PD patients: AUC=0.684, 0.810 and 0.849 respectively; 95% CI：0.533～0.836, 0.679～0.941 and 0.736～0.962 respectively; P=0.027, ＜0.001 and ＜0.001 respectively).  Conclusion  Age, PLR, cystatin C and Hcy are the independent risk factors for CI in MHD patients; age, PLR, hemoglobin and 25-hydroxy-vitamin-D are the independent risk factors for CI in PD patients. Therefore, these factors should be closely monitored during treatment of MHD and PD patients. Early intervention of these factors may delay or avoid the occurrence of CI in dialysis patients.

Key words: End-stage renal disease, Cognitive impairment, Maintenance hemodialysis, Peritoneal dialysis