{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:01:25Z","timestamp":1785456085801,"version":"3.56.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Jikei University Research Fund"},{"name":"Jikei University Graduate Research Fund"},{"name":"JSPS KAKENHI","award":["20K17259"],"award-info":[{"award-number":["20K17259"]}]},{"name":"JSPS KAKENHI","award":["23K07727"],"award-info":[{"award-number":["23K07727"]}]},{"DOI":"10.13039\/501100007638","name":"The Kidney Foundation, Japan","doi-asserted-by":"crossref","award":["JKFB21-15"],"award-info":[{"award-number":["JKFB21-15"]}],"id":[{"id":"10.13039\/501100007638","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100007638","name":"The Kidney Foundation, Japan","doi-asserted-by":"crossref","award":["JKFB23-7"],"award-info":[{"award-number":["JKFB23-7"]}],"id":[{"id":"10.13039\/501100007638","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cognitive impairment is common among patients undergoing hemodialysis and worsens their quality of life and survival. The programmed cell death 1 (PD-1) pathway\u2014comprising the receptor PD-1 and its ligand programmed cell death ligand 1 (PD-L1)\u2014was initially recognized as a mechanism of tumor immune evasion that was also involved in chronic inflammation and immune aging. However, its role in cognitive impairment remains poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross-sectional study, patients aged \u226565 years undergoing hemodialysis were recruited from 7 centers. Global cognitive function was assessed by the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). Serum soluble PD-1 (sPD-1) and soluble PD-L1 (sPD-L1) were measured by enzyme-linked immunosorbent assay. Multivariable logistic regression was used to adjust for age, sex, dialysis vintage, C-reactive protein, and other confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median age of the 384 patients was 74 years (interquartile range, 70\u201380), 67.5% were male, 61.2% scored below the MoCA score cutoff of 26, and 10.2% scored below the MMSE score cutoff of 24. Higher sPD-1 levels were associated with cognitive impairment as defined by both assessment tools; moreover, higher sPD-L1 levels were associated with MoCA-defined impairment (odds ratio, 2.53; 95% confidence interval, 1.26\u20135.06, P = .009). The association between sPD-1 and MMSE-defined impairment was stronger in patients without cancer history.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings highlight the potential role of the PD-1 pathway in risk stratification and future interventions in cognitive impairment in patients undergoing hemodialysis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/joneph\/aajag048","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T12:42:03Z","timestamp":1771591323000},"page":"556-563","source":"Crossref","is-referenced-by-count":0,"title":["Programmed cell death 1 pathway and cognitive function in patients undergoing hemodialysis"],"prefix":"10.1093","volume":"39","author":[{"given":"Kazuhiko","family":"Kato","sequence":"first","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal 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,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayaka","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine , Tokyo ,","place":["Japan"]},{"name":"Division of Molecular Epidemiology, The Jikei University School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arisa","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine , Tokyo ,","place":["Japan"]},{"name":"Human Health Sciences, Kyoto University Graduate School of Medicine , Kyoto ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunichiro","family":"Shinagawa","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, The Jikei University 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