{
  "abstract": "Cognitive dysfunction is increasingly recognized as a significant complication of chronic kidney disease (CKD), but the clinical relevance of protein-bound uremic toxins (PBUTs) to cognition remains insufficiently characterized. This cross-sectional analysis included 1217 community-dwelling individuals. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), with scores < 28 indicating possible mild cognitive impairment (MCI). Serum concentrations of five PBUTs-indoxyl sulfate, p-cresyl sulfate, phenyl sulfate, indoleacetic acid, and hippuric acid-were measured, and a composite PBUT score was derived using principal component analysis. Multivariable logistic regression was used to examine the associations of MCI with the PBUT score and with each PBUT. Serum PBUT concentrations increased with advancing CKD stage. The mean MMSE score was 26.7 ± 3.4, and scores progressively declined with advancing CKD stage. A higher PBUT score was independently associated with MCI (coefficient, 0.290 ± 0.077; odds ratio, 1.337; 95% confidence interval, 1.151-1.554; p < 0.001). In conclusion, a greater PBUT burden was independently associated with cognitive impairment. These findings identify PBUT burden as a potential correlate of cognitive impairment in CKD. Prospective studies are needed to clarify its temporal relationship with cognitive decline and to assess whether it provides predictive value beyond established measures of kidney function.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Clinical Nephrology and Rheumatology, Kidney Research Center, Graduate School of Medicine, Dentistry and Health Sciences, Niigata University, Niigata 951-8510, Japan.",
    "Clinical and Translational Research Center, Niigata University Medical and Dental Hospital, Niigata 951-8510, Japan.",
    "Department of Inter-Organ Communication Research, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan.",
    "Sado General Hospital, Niigata 952-1209, Japan.",
    "Research and Development Division, Kureha Corporation, Tokyo 103-8552, Japan."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 14,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Suguru Yamamoto",
      "orcid": "0000-0002-8279-2966"
    },
    {
      "affs": [
        1
      ],
      "name": "Takahiro Tanaka"
    },
    {
      "affs": [
        1
      ],
      "name": "Nobutaka Kitamura",
      "orcid": "0000-0001-6257-3144"
    },
    {
      "affs": [
        0
      ],
      "name": "Miho Kawachi"
    },
    {
      "affs": [
        2
      ],
      "name": "Akio Yokoseki"
    },
    {
      "affs": [
        2
      ],
      "name": "Minako Wakasugi",
      "orcid": "0000-0003-1555-7736"
    },
    {
      "affs": [
        2
      ],
      "name": "Osamu Onodera",
      "orcid": "0000-0003-3354-5472"
    },
    {
      "affs": [
        2
      ],
      "name": "Naoto Endo"
    },
    {
      "affs": [
        3
      ],
      "name": "Masakazu Wada"
    },
    {
      "affs": [
        3
      ],
      "name": "Kenji Sato"
    },
    {
      "affs": [
        4
      ],
      "name": "Kaori Kikuchi"
    },
    {
      "affs": [
        4
      ],
      "name": "Ayano Konagai"
    },
    {
      "affs": [
        0
      ],
      "name": "Shin Goto",
      "orcid": "0000-0002-6167-555X"
    },
    {
      "affs": [
        0
      ],
      "name": "Ichiei Narita"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/b84xmvq4mnk6z.bib",
  "cited_by": 0,
  "doi": "10.3390/toxins18100422",
  "fulltext_url": "https://europepmc.org/articles/PMC13709565",
  "id": "b84xmvq4mnk6z",
  "issns": [
    "2072-6651"
  ],
  "landing_url": "https://europepmc.org/article/MED/42931513",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2727|Dialysis and Renal Disease Management"
    ]
  ],
  "openalex": "W7214891739",
  "pdf_url": "https://europepmc.org/articles/PMC13709565?pdf=render",
  "pmcid": "PMC13709565",
  "pmid": "42931513",
  "published": "2026-09-30",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/b84xmvq4mnk6z.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:22:01Z",
      "native_id": "MED:42931513",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42931513"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2727|Dialysis and Renal Disease Management",
      "subfield": "general"
    }
  ],
  "title": "Protein-Bound Uremic Toxins and Cognitive Function: A Cross-Sectional Study in a Community-Based Cohort.",
  "title_text": "Protein-Bound Uremic Toxins and Cognitive Function: A Cross-Sectional Study in a Community-Based Cohort.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:22:01Z",
  "url": "https://research.draconitic.com/paper/b84xmvq4mnk6z",
  "venue": "Toxins",
  "versions": []
}