Cognitive Impairment and Associated Factors among Chronic Kidney Disease Patients: A Comparative Cross-Sectional Study

Background: Cognitive impairment is one of the public health problems affecting 50 million people in the world. Chronic kidney disease (CKD) patients are at high risk to develop cognitive impairment which leads to poor quality of life, difficulty in adhering to medications, increased risk of mortality, and health resource utilization. However, there is no study done on the prevalence of cognitive impairment and associated factors among chronic kidney disease patients in Ethiopia. Objective: This study aimed to assess the prevalence of cognitive impairment and associated factors among chronic kidney disease patients at the University of Gondar Comprehensive Specialized and Felege Hiwot Referral Hospitals in 2020, Northwest Ethiopia, 2020. Methods: An institution-based comparative cross-sectional study was conducted at the University of Gondar Comprehensive Specialized and Felege Hiwot Referral Hospitals in 2020. A systematic random sampling technique was used to select the study participants. Data were collected using standard tools. Data were checked for its completeness and entered into Epi data version 3.0 then exported into STATA 14. Multi-variable logistic regression analysis was employed to identify associated factors of cognitive impairment among CKD patients, and variables having a p-value of <= 0.05 were declared as significant. Results: In this study, 116 CKD patients and 116 age, sex, and educational level matched controls were included with a response rate of 100%. The prevalence of cognitive impairment was 49.1% [95% CI (40%, 58.3%)] among CKD patients and 28.4% [95% CI (20.9%, 37.5%)] among controls. Independent predictors of cognitive impairment among CKD patients were estimated glomerular filtration (eGFR) <60mL/min/m(2) [AOR=3.9, 95% CI (1.1-14.74)], proteinuria [AOR=6.0, 95% CI (1.83-20.3)], age greater than 65 years [AOR=4.0, 95% CI (1.12-14.64)], and educational level of grade 8 and less [AOR=4.7, 95% CI (1.22-18.47)]. Conclusion: The prevalence of cognitive impairment among CKD patients was higher than healthy controls. Cognitive impairment was higher among CKD patients with eGFR <60mL/min/m(2), proteinuria, educational level of grade 8 and less, and age greater than 65 years. Therefore, there is a need to have a regular evaluation and follow-up of CKD patients for cognitive impairment.