Association of Cognitive Function with Albuminuria and eGFR in the General Population

Abstract

SummaryBackground and objectives Recent studies found different associations of cognitive function with albuminuria or estimated GFR (eGFR). Most studies were limited to the elderly or did not take both renal variables into account. Therefore, this study analyzed the association of cognitive function with albuminuria and eGFR in community-dwelling persons aged 35 to 82 years. ResultsThe prevalence of albuminuria Ͻ10, 10 to 29, and Ն30 mg/24 h was 54%, 31%, and 15%, respectively. Mean eGFR (Ϯ SD) was 79 Ϯ 15 ml/min per 1.73 m 2 . Because of interaction between albuminuria and age, analyses were performed per age tertile. After multivariate adjustment, albuminuria Ն 30 mg/24 h, but not eGFR, was associated with lower RFFT score in the youngest tertile (B Ϫ5.3; 95% CI, Ϫ0.6 to Ϫ9.2; P ϭ 0.05), but not in older tertiles. Moreover, subjects in the youngest tertile with increasing albuminuria (5-15 and Ͼ15 mg/24 h) before RFFT measurement had lower mean RFFT scores than subjects with stable albuminuria: mean difference Ϫ4.9 (P ϭ 0.3) and Ϫ6.7 (P ϭ 0.03), respectively. ConclusionsIn this community-based cohort, elevated albuminuria was associated with worse cognitive function in young but not in old persons. There was no association of eGFR with cognitive function.

Estimated Glomerular Filtration Rate is not Associated with Alzheimer’s Disease in a Northern Ireland Cohort

“…Our findings support previous reports that showed no association between eGFR and cognitive impairment [6,[20][21][22], but contrast to those that did report a significant association [5,9,[23][24][25][26][27][28][29][30]. In addition, other studies also reported significant associations between renal impairment characterised by the presence of microalbuminuria and cognitive impairment [10,20,21,31].…”

“…In addition, other studies also reported significant associations between renal impairment characterised by the presence of microalbuminuria and cognitive impairment [10,20,21,31]. A recent meta-analysis of five population based prospective studies included 27,805 participants, demonstrated a non-significant increased risk of cognitive impairment or dementia in those with an eGFR < 60 ml/min/1.73m 2 , with a significant association found only in those with albuminuria [7].…”

Cardiovascular Risk Profile and Cognitive Function in Young, Middle-Aged, and Elderly Subjects

“…Second, the PREVEND cohort is enriched for elevated albuminuria, which could induce selection bias, because albuminuria is a risk factor for CVD. 15 However, a sensitivity analysis in a subsample, representative for the general population, did not change results. Finally, the cross-sectional design of this study does not formally allow a firm conclusion on a causal relationship.…”

“…15 Of those with a complete RFFT score, subjects with a history of CVD or stroke (n=311; 5%) or with missing data on components of the FRS or educational level (n=66; 1%) were excluded. Three participants aged <35 years were excluded because their number was too small to form a separate age group.…”

To Predict Dementia, Should We Be Mindful of the Kidneys?

“…The study by Joosten et al (5) in this issue of CJASN addresses this question. Using data from the Prevention of Renal and Vascular End-stage Disease (PRE-VEND) study, a community-based cohort study in the Netherlands, Joosten et al evaluated the association between baseline and longitudinal measurements of albuminuria and eGFR with cognitive function in 4095 participants with a mean age of 55 years.…”