Patients with chronic kidney disease are at an elevated risk of dementia: A population-based cohort study in Taiwan

Abstract

BackgroundChronic kidney disease (CKD) is more prevalent in Taiwan than in most countries. This population-based cohort study evaluated the dementia risk associated with CKD.MethodsUsing claims data of 1,000,000 insured residents covered in the universal health insurance of Taiwan, we selected 37049 adults with CKD newly diagnosed from 2000–2006 as the CKD cohort. We also randomly selected 74098 persons free from CKD and other kidney diseases, frequency matched with age, sex and the date of CKD diagnosed. Incidence and hazard ratios (HRs) of dementia were evaluated by the end of 2009.ResultsSubjects in the CKD cohort were more prevalent with comorbidities than those in the non-CKD cohort (p <0.0001). The dementia incidence was higher in the CKD cohort than in the non-CKD cohort (9.30 vs. 5.55 per 1,000 person-years), with an overall HR of 1.41 (95% confidence interval (CI), 1.32-1.50), controlling for sex, age, comorbidities and medicaitions. The risk was similar in men and women but increased sharply with age to an HR of 133 (95% CI, 68.9-256) for the elderly. However, the age-specific CKD cohort to non-CKD cohort incidence rate ratio decreased with age, with the highest ratio of 16.0 (95% CI, 2.00-128) in the youngest group. Among comorbidities and medications, alcoholism and taking benzodiazepines were also associated with dementia with elevated adjusted HRs of 3.05 (95% CI 2.17-4.28) and 1.23 (95% CI 1.14-1.32), respectively.ConclusionsPatients with CKD could have an elevated dementia risk. CKD patients with comorbidity deserve attention to prevent dementia.

Cardiorenal Metabolic Syndrome and Diabetic Cognopathy

“…Renal disease is a major component of the CRS [51,52], and independently, renal disease is associated with diabetes, hypertension, and hyperlipidemia as occurs in the CRS. The progression of CRS-associated renal dysfunction to chronic kidney disease is linked to increases in oxidative stress, inflammation, chronic anemia, vascular calcification, and increased homocysteine, uric acid, and parathyroid hormone [53].…”

Correlation between proton pump inhibitors and risk of pyogenic liver abscess

“…All comorbidities, including pyogenic liver abscess, were also diagnosed according to ICD-9 codes, the accuracy of which has been validated in previous studies [40][41][42][43][44][45][46][47][48][49][50][51][52]. Finally, we had a large sample, a sound study design, and appropriate statistical methods.…”

A Review of Chronic Kidney Disease and the Immune System: A Special Form of Immunosenescence

“…A meta-analysis of cross-sectional and longitudinal studies comprising 54,779 participants, suggested an association of cognitive decline in CKD patients compared with patients without CKD (OR 1.65, 95% confidence interval (CI) 1.32-2.05; p<0.001; OR 1.39, 95% CI 1.15¬¬-1.68; p<0.001, respectively) [73]. In Taiwan that has the highest prevalence rate of ESRD worldwide, the incidence of dementia was higher in the CKD cohort than in the non-CKD cohort (9.30 vs. 5.55 per 1,000 person-years), with an overall hazard ratio (HR) of 1.41 (95% confidence interval (CI), 1.32-1.50), controlling for sex, age, comorbidities, and medications [74]. Therefore, CKD is a significant and independent somatic risk factor in the development of cognitive decline.…”