Moderate Chronic Kidney Disease and Cognitive Function in Adults 20 to 59 Years of Age

Hailpern, Susan M.; Melamed, Michal L.; Cohen, Hillel W.; Hostetter, Thomas H.

doi:10.1681/asn.2006101165

Cited by 185 publications

(137 citation statements)

References 32 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%

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%

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 findings emphasize that dynamic characteristics of albuminuria are important determinants of cognitive decline. Several studies have shown that moderate CKD can be associated with impaired cognition (38)(39)(40)(41). There are few studies, however, that have longitudinally examined the effect of eGFR decline on cognition.…”

Section: Discussionmentioning

confidence: 99%

Albuminuria and Cognitive Decline in People with Diabetes and Normal Renal Function

Barzilay¹,

Lovato²,

Murray³

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Diabetes mellitus is associated with increased risk of cognitive impairment. This study examines whether microvascular disease, as measured by albuminuria and decline in estimated GFR (eGFR), is associated with cognitive decline during 3.3 years of follow-up in individuals with diabetes with a normal baseline eGFR (approximately 90 ml/min per 1.73 m 2 ). Mixed-effects models were used to assess the association of albuminuria and eGFR on the percentage decline in each test.Results Participants with albuminuria at baseline and follow-up (persistent albuminuria) (25.8% [95% confidence interval (CI), 27.3 to 24.2]) and participants with albuminuria at follow-up but none at baseline (progressive albuminuria) (24.1% [95% CI, 25.6 to 22.7]) had greater percentage declines on information processing speed than participants without albuminuria at baseline and at follow-up (no albuminuria) (22.6% [95% CI, 23.4 to 21.9]) (P=0.001 and P=0.10, respectively). There were borderline percentage changes in the test of verbal memory (4.8% [95% CI, 2.4 to 7.1] and 4.7% [95% CI, 2.5 to 7.0] versus 7.1% [95% CI, 6.0 to 8.3]; P=0.11 and P=0.08, respectively). On logistic regression analysis, persistent albuminuria (odds ratio, 1.37 [95% CI, 1.09 to 1.72]) and progressive albuminuria (odds ratio, 1.25 [95% CI, 1.02 to 1.56]) were associated with a $5% decline in information processing speed scores but not with verbal memory or executive function performance. A 1 ml/min per 1.73 m 2 per year eGFR decline had a borderline association with decline in tests of cognitive function.Conclusions Persistent albuminuria and progressive albuminuria are associated with a decline in cognitive function in relatively young individuals with diabetes with unimpaired eGFR. These findings do not rule out the possibility of other processes causing cognitive decline.

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“…Declarative memory also depends on signals from the hippocampus and other parts of the medial temporal lobe of the brain for its retention. Neuropsychological studies have found loss of memory and defects in cognition as silent features of renal failure in patients (Hailpern et al 2007). Another explanation for the association of the kidney with cognitive dysfunction is the accumulation of retention solutes.…”

Section: Memory Retention and Cognitionmentioning

confidence: 99%

Psychomotor functions at various weeks of chronic renal failure in rats

Chandanathil¹,

Upadhya

Bhat³

2014

Cogn Neurodyn

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In chronic renal failure there is a gradual retention of substances in the tissues and body fluids, called as uremic retention toxins, which can bring about a number of biochemical activities in the body. Chronic renal insufficiency also leads to progressive behavioural conflict. Uremic toxins can affect both the central and the peripheral nervous system. Uremic encephalopathy is also associated with problems in cognition and memory. To study the psychomotor functional disorders in rats with progressive chronic renal failure surgical nephrectomy was done by resection method. The animals were grouped into two control groups, Sham control (SC) and normal control (NC) and two uremic groups, moderate uremia (G M ) and severe uremia (G S ). Psychomotor analysis was done by passive avoidance and open field in these animals at 4, 8, 12, and 16 weeks. After the incubation period, the nephrectomised groups (G M and G S ) showed significant changes in exploratory, locomotor and emotional behaviour when compared to the controls (NC and SC). Psychomotor changes involve poor cognition, reduced memory, reduced locomotor activity and decreased exploratory drive and emotional disturbance like increased fear during the initial stages. During the later stages a restless behaviour was noticed, associated with diminished fear.

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Moderate Chronic Kidney Disease and Cognitive Function in Adults 20 to 59 Years of Age

Cited by 185 publications

References 32 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

Albuminuria and Cognitive Decline in People with Diabetes and Normal Renal Function

Psychomotor functions at various weeks of chronic renal failure in rats

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