Abstract: Objective This study was to explore the association of malnutrition - inflammation - atherosclerosis syndrome (MIA) with cognitive function in peritoneal dialysis (PD) patients. Methods A total of 240 clinically stable patients who performed PD for at least 3 months were enrolled. The global cognitive function and specific cognitive functions were investigated. Demographic and biochemical data were recorded. Serum albumin ≤35g/L and high sensitive C-reactive protein ≥3mg/L were used to diagnose malnutrition and inflammation respectively in these patients. MIA0 referred to those without any of the 3 abnormalities, and MIA1 and MIA2 referred to those with one and 2～3 abnormalities respectively. Results The prevalence of malnutrition, inflammation and cardiovascular disease was 15.0% (n=36), 47.5% (n=114), and 35.8% (n=86) respectively. The numbers of patients in MIA0, MIA1, and MIA2 group were 79 (32.9%), 87 (36.3%), and 74 (30.8%) respectively. The prevalence of global cognitive impairment was 6 (7.6%), 16 (18.4%), and 15 (20.3%) in MIA0, MIA1, and MIA2 groups respectively. As compared to MIA0 group, patients in MIA2 and MIA1 groups had significantly lower 3MS scores (t=3.629, P＜0.001; t=-2.518, P=0.013), higher prevalence
of cognitive impairment (χ2=5.184, P=0.023; χ2=4.197, P=0.040) and executive dysfunction (χ2=14.574, P＜0.001; χ2=6.817, P=0.009), and longer time on completing trails B (χ2=9.317, P=0.002; χ2=4.236, P=0.040). The time on completing trails A (χ2=7.281, P=0.007; χ2=15.028, P＜0.001) was longer and the scores of visuospatial skills (t=2.122, P=0.035; t=2.893, P=0.004) were lower in MIA2 group than in MIA1 and MIA0 groups. The scores of immediate memory were lower in MIA2 group than in MIA0 group (t=2.071, P=0.040). Conclusion The MIA syndrome was closely associated with cognitive impairment in PD patients. Patients with two factors of MIA were prone to have severer cognitive impairment than those without MIA or with one factor of MIA.

Key words: Peritoneal dialysis, Malnutrition, Inflammation, Cardiovascular disease, Cognitive function