ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition, Psychology and Brain Health
Association of NPAR with cognitive impairment in peritoneal dialysis Patients
Provisionally accepted
- Beijing Luhe Hospital, Capital Medical University, Beijing, China
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Background: The neutrophil percentage-to-albumin ratio (NPAR) is a novel inflammatory mark er. This study explored its association with cognitive impairment (CI) in peritoneal dialysis (PD) patients. Methods: In this cross-sectional study, 152 PD patients were categorized into CI (Montreal Co gnitive Assessment (MoCA) score <26) or non-CI (MoCA ≥26) groups. Results: CI was present in 66.45% of PD patients. Patients in CI groups had older age (63.01 ± 10.88 vs. 49.75 ± 12.74 years, P < 0.001), high proportion of female (43.56% vs 23.53, P = 0.016) and higher NPAR (1.94 ± 0.24 vs. 1.80 ± 0.24, P = 0.001). In addition, patients i n CI groups had lower level of education (8.24 ± 2.97 vs. 11.55 ± 3.45 years, P < 0.001), s erum albumin (36.29 ± 3.56 vs. 37.75 ± 2.60 g/L, P = 0.010), potassium (4.30 ± 0.71 vs. 4. 51 ± 0.53 mmol/L, P = 0.039), creatinine (865.79 ± 274.38 vs. 1099.92 ± 293.86 umol/L, P < 0.001) and phosphorus (1.43 ± 0.41 vs. 1.68 ± 0.44 mmol/L, P = 0.001). Multivariate logis tic regression revealed that NPAR, age, serum phosphorus and education were significant indep endent determinants of CI. The area under the curve (AUC) of NPAR for predicting CI was 0. 657, with a sensitivity of 0.495 and a specificity of 0.745, P = 0.002. When combining age, NPAR, blood phosphorus and education, the AUC increased to 0.861 with a sensitivity of 0.82 2 and a specificity of 0.725, P < 0.001. Conclusion: CI in PD patients was found to be independently associated with elevated NPAR. NPAR may serve as a potential biological indicator for identifying prevalent CI, providing a basis for further exploration of early intervention strategies for CI.
Keywords: Chronic Kidney Disease, cognitive impairment, NPAR, Peritoneal Dialysis, Risk factors
Received: 24 Nov 2025; Accepted: 16 Feb 2026.
Copyright: © 2026 Liu, Shao, Wang, CAI and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhongxin Li
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