Hippocampal Volume Mediates the Association Between Serum Ferritin and Cognition in Non-Dialysis End-Stage Renal Disease Patients.

OBJECTIVE: Quantitatively assess the characteristics of brain volume in end-stage renal disease (ESRD) individuals through high-resolution structural MRI, analyze the relationship between these features and cognitive impairment, as well as explore associated risk factors. METHODS: Fifty ESRD subjects and 48 healthy controls, matched by demographics, participated in the study. Each participant underwent neuropsychological assessments and 3.0T MRI scans, with cerebral volume data obtained via voxel-based morphometry. RESULTS: ESRD patients showed significantly lower scores in mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA), along with reduced gray matter volume (GMV) that was positively correlated with cognitive scores. After adjusting for confounding factors, serum ferritin levels independently served as a risk factor contributing to the decrease in GMV, with hippocampal volume partially mediating the ferritin-cognition association. CONCLUSIONS: Lower serum ferritin levels may exert a protective effect against the decrease in gray matter volume and the deterioration of cognitive function in non-dialysis ESRD individuals.