Publications & Posters

Plasma Aβ42/Aβ40 ratio as a biomarker for cognitive impairment in patients undergoing hemodialysis: a multi-center study 

Clinical Kidney Journal | July 19, 2023

Xujiao Chen, Mengjing Wang, Jianying Niu, Jun Ma, Jing Qian, Li Ni, Ping Cheng, Huaizhou You, Jing Chen

Clinical Kidney Journal, 2023

This study was performed using Simoa Homebrew assay(s).



Mild cognitive impairment (MCI) and dementia, are more prevalent in patients undergoing hemodialysis. Although the cerebrospinal fluid amyloid beta (Aβ) and tau have proven to be valid biomarkers for the diagnosis of Alzheimer’s disease in the general population, the roles of plasma Aβ and tau for the diagnosis of cognitive impairment in patients undergoing hemodialysis remain unknown.


We conducted a cross-sectional study including patients receiving hemodialysis in three hospitals in Shanghai. All patients completed the Montreal Cognitive Assessment Basic (MoCA-B). To validate the effectiveness of MoCA-B score for screening MCI, a subset group underwent neuropsychological batteries. Serum proteomes were compared in patients with normal cognitive function and dementia undergoing HD. Plasma Aβ42, Aβ40, and total tau were measured using a single molecule array.


A total of 311 patients undergoing hemodialysis were enrolled (mean age, 63 years; 55% male). The best cut-off score of MoCA-B for differentiating MCI and normal cognition was 24 with an area under the curve of 0.94. Serum proteomics revealed that neurodegenerative pathways related to Alzheimer’s disease were enriched in patients with dementia undergoing hemodialysis. The plasma Aβ42/Aβ40 ratio was significantly reduced in patients with MCI and dementia. The plasma Aβ42/Aβ40 ratio was independently associated with cognitive function after adjusting for age, sex, and educational levels.


We validated the MoCA-B as an optimal cognitive function screening instrument for MCI in patients undergoing hemodialysis. The plasma Aβ42/Aβ40 ratio was a potential biomarker in distinguishing normal cognition, MCI, and dementia in populations undergoing hemodialysis.