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:
The aim of the study wasto evaluate the effect of Mexidol as part of a 10-week combination therapy for cognitive impairment on cognitive status, quality of life parameters, and renal function in comorbid patients with microalbuminuria and arterial hypertension (AH) and type 2 diabetes mellitus (DM).

Materials and methods. A prospective, open, randomized study included 60 comorbid patients (1:1) with hypertension and type 2 diabetes, cognitive impairment ≤24 points on the Montreal Cognitive Assessment (MoCA) and microalbuminuria (urine albumin/creatinine ≥30 mg/g). The mean age of patients was 64.8±10.3 years, 50% were male. 30 patients were included in the standard therapy group with additional prescription 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 impact of therapy on patients' cognitive status was assessed using the MoCA, quality of life parameters using the Minnesota Heart Facts Questionnaire (MLHFQ),
Kansas City Cardiomyopathy Questionnaire (KCCQ), and the SF-36 "Quality of Life Assessment" questionnaire, the severity and dynamics of asthenic syndrome using the subjective asthenia assessment scale (MFI-20), and the anxiety level using the Beck Anxiety Inventory. At baseline, after 14 days, and at the end of the study, renal function was assessed using serum creatinine and cystatin C levels, estimated glomerular filtration rate (SCF) based on creatinine (eSCFcr), eSCF based on blood cystatin C (eSCFcys), and the urine albumin/creatinine ratio.

Results: Patients receiving Mexidol in addition to standard therapy showed a significant improvement in cognitive function according to the MoCA scale by 20% (p

Conclusion. Mexidol, when added to standard therapy in comorbid patients with microalbuminuria associated with hypertension and type 2 diabetes, significantly improves cognitive status, quality of life, reduces the severity of asthenic syndrome and anxiety, and improves renal function.

Key words: microalbuminuria, cognitive impairment, cognitive status, quality of life, diabetic nephropathy, renal function, Mexidol.