The effect of Mexidol on improving quality of life parameters and functional state of the kidneys as part of complex therapy for cognitive impairment in comorbid patients with microalbuminuria against the background of arterial hypertension and type 2 diabetes mellitus

V.V. TOLKACHEVA, L.V. KARAPETYAN, L.G. EZHOVA, N.I. KHUTSISHVILI, N.I. KONTAREVA,
S.A. GALOCHKIN, E.R. KAZAKHMEDOV, J.D. KOBALAVA

FGAOU in Russian University of Friendship of Peoples named after Patrice Lumumba, Moscow, Russia

Place of publication:
Cardiology and cardiovascular surgery, 2025, Vol. 18, No. 4, pp. 478–489

Abstract:
Objective of the study . To evaluate the effect of Mexidol as part of complex therapy for cognitive impairment for 10 weeks on cognitive status, quality of life parameters and renal function in comorbid patients with microalbuminuria against the background of arterial hypertension (AH) and type 2 diabetes mellitus (DM).

Materials and methods. The prospective open randomized study included 60 comorbid patients (1:1) with hypertension and type 2 diabetes mellitus, cognitive impairment ≤24 points on the Montreal Cognitive Assessment (MoCA) and microalbuminuria (urine albumin/creatinine ≥30 mg/g). The average age of patients was 64.8±10.3 years, 50% were male. 30 patients were included in the standard therapy group with additional administration of mexidol (200 mg intramuscularly once a day for 14 days, then 125 mg 3 times a day for 8 weeks) and 30 patients in the standard therapy group. At baseline and at the end of the study, the effect of therapy on the cognitive status of patients was assessed using MoCA, quality of life parameters based on the Minnesota Heart Questionnaire (MLHFQ),
Kansas City Cardiomyopathy Questionnaire (KCCQ), and SF-36 questionnaires, the severity and dynamics of asthenic syndrome using the subjective asthenia assessment scale (MFI-20), and the anxiety level using the Beck scale. At baseline, after 14 days, and at the end of the study, the functional state of the kidneys was assessed using serum creatinine and cystatin C levels, estimated glomerular filtration rate (SCF) based on creatinine levels (eSCFcr), eSCF based on cystatin C levels (eSCFcys) in the blood, and the albumin/creatinine ratio in the urine.

Results. Patients receiving Mexidol in addition to standard therapy showed a significant improvement in cognitive function according to the MoCA scale by 20% (p<0.001), an improvement in the quality of life according to the Minnesota questionnaire by 21% (p<0.001), according to the Kansas questionnaire by 12% (p=0.05), a decrease in the severity of asthenic syndrome by 18% (p<0.001) and the level of anxiety by 41% (p<0.001), a significant improvement in the functional state of the kidneys in the form of a decrease in albuminuria by 71% (p<0.001), creatinine by 7.3% (p<0.01), cystatin C by 18% (p<0.001), an increase in eGFRcr by 8.7% (p<0.001), eGFRcys by 11.28% (p<0.001).

Conclusion. Mexidol, when added to standard therapy of comorbid patients with microalbuminuria against the background of hypertension and type 2 diabetes, significantly improves cognitive status, quality of life parameters, reduces the severity of asthenic syndrome and anxiety levels, and improves the functional state of the kidneys.

Key words: microalbuminuria, cognitive impairment, cognitive status, quality of life, diabetic nephropathy, functional state of the kidneys, Mexidol.