Chronic kidney disease, creatinine and cognitive functioning

Elias, Merrill F.; Elias, Penelope K.; Seliger, Stephen L.; Narsipur, Sriram S.; Dore, Gregrory A.; Robbins, Michael A.

doi:10.1093/ndt/gfp107

Cited by 177 publications

(197 citation statements)

References 38 publications

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“…However, this finding is in contrast to most other previous cross-sectional studies (10,11,(42)(43)(44). Our results may differ from these studies because of various population characteristics.…”

Section: Discussioncontrasting

confidence: 99%

“…Our communitybased population comprised a considerable number of young subjects with normal or moderately impaired eGFR, whereas others focused on elderly or high-risk populations (9 -11,37) and included higher numbers of people with low eGFR (10,11,42,43). Another explanation might be that most previous studies did not take albuminuria into account as a possible confounder (37,(42)(43)(44). This assumption is supported by the fact that in our study eGFR did show a significant association with cognitive function in our high-risk elderly patients, but only when not accounting for albuminuria.…”

Section: Discussionmentioning

confidence: 99%

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

Joosten

Izaks

Slaets

et al. 2011

Clinical Journal of the American Society of Nephrology

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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.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Joosten

Izaks

Slaets

et al. 2011

Clinical Journal of the American Society of Nephrology

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“…These data are especially notable; several studies suggest that cognition and memory are impaired in patients with renal disease, particularly during dialysis (21)(22)(23). Other studies have demonstrated limited health care literacy, independently influenced by ethnicity and socioeconomic factors, among dialysis patients (24).…”

Section: Communicationmentioning

confidence: 99%

Patient and Facility Safety in Hemodialysis

Garrick

Kliger

Stefanchik

2012

Clinical Journal of the American Society of Nephrology

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SummaryPatient safety is the foundation of high-quality health care. More than 350,000 patients receive dialysis in the United States, and the safety of their care is ultimately the responsibility of the facility medical director. The medical director must establish a culture of safety in the dialysis unit and lead the quality assessment and performance improvement process. Several lines of investigation, including surveys of patients and dialysis professionals, have helped to identify important areas of safety risk in dialysis facilities. Among these are lapses in communication, medication errors, patient falls, errors in machine and membrane preparation, failure to follow established policies, and lapses in infection control. The quality assessment and performance improvement process should include a dedicated safety team to focus on specifically identified areas of risk and to establish outcome goals guided by best practices and agreed-upon measures of success. A safety questionnaire can be given to patients and staff and the responses evaluated to improve understanding of the prevailing attitudes and concerns about safety. By sharing these results, openly acknowledging the challenges, and using a blame-free root cause process to identify action plans, the facility can begin to establish a culture of safety.

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“…Of interest, with regard to CKD, it is the cognitive performance measures involving visual-spatial organization and scanning and tracking that appear to be the most sensitive to kidney function (Elias et al, 2009;Torres et al, 2017). Thus, it is also possible that VA is merely a marker for comorbid cardiovascular disease (CVD) rather than an independent predictor of cognitive performance.…”

Section: Introductionmentioning

confidence: 99%

Poorer Visual Acuity Is Associated with Declines in Cognitive Performance Across Multiple Cognitive Domains: The Maine-Syracuse Longitudinal Study

Dearborn

Elias

Sullivan

et al. 2018

J Int Neuropsychol Soc

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Objectives: Prior studies have found associations between visual acuity (VA) and cognitive function. However, these studies used a limited range of cognitive measures and did not control for cardiovascular disease risk factors (CVD-RFs) and baseline function. The primary objective of this study was to analyze the associations of VA and cognitive performance using a thorough neuropsychological test battery. Methods: This study used community-dwelling sample data across the sixth (2001)(2002)(2003)(2004)(2005)(2006) and seventh (2006)(2007)(2008)(2009)(2010) waves of the Maine-Syracuse Longitudinal Study (n = 655). Wave 6 VA as measured by the Snellen Eye Test was the primary predictor of wave 6 and wave 7 Global cognitive performance, Visual-Spatial Organization and Memory, Verbal Episodic Memory, Working Memory, Scanning and Tracking, and Executive Function. Additionally, VA was used to predict longitudinal changes in wave 7 cognitive performance (wave 6 performance adjusted). We analyzed these relationships with multiple linear and logistic regression models adjusted for age, sex, education, ethnicity, depressive symptoms, physical function deficits in addition to CVD-RFs, chronic kidney disease, homocysteine, continuous systolic blood pressure, and hypertension status. Results: Adjusted for demographic covariates and CVD-RFs, poorer VA was associated with concurrent and approximate 5-year declines in Global cognitive function, Visual-Spatial Organization and Memory, and Verbal Episodic Memory. Discussion: VA may be used in combination with other screening measures to determine risk for cognitive decline. (JINS, 2018, 24, 746-754)

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Chronic kidney disease, creatinine and cognitive functioning

Abstract: Global performance and specific cognitive functions are negatively affected early in CKD. Targeted screening for cognitive deficits in kidney disease patients early in their disease course may be warranted.

Cited by 177 publications

References 38 publications

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

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

Patient and Facility Safety in Hemodialysis

Poorer Visual Acuity Is Associated with Declines in Cognitive Performance Across Multiple Cognitive Domains: The Maine-Syracuse Longitudinal Study

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