Albuminuria in Association with Cognitive Function and Dementia: A Systematic Review and Meta‐Analysis

Abstract

Albuminuria was independently associated with cognitive impairment, dementia and cognitive decline. The stronger effects for vascular dementia and cognitive performance in domains primarily affected by microvascular disease support that the association could be mediated by shared microvascular pathology in the kidney and the brain.

Albuminuria and Cerebral Small Vessel Disease: A Systematic Review and Meta‐Analysis

“…In our recent meta‐analysis, we showed that albuminuria was associated with greater risk of dementia and cognitive decline in the general population cross‐sectionally and longitudinally . When classifying according to subtype, the effect size was stronger for vascular dementia, but the odds remained high for Alzheimer's disease.…”

“…In a previous meta‐analysis, we showed that albuminuria is associated with risk of dementia and cognitive decline . We hypothesized that this is the result of concurrent SVD pathology in the kidney and the brain, and there is evidence of an association between albuminuria and SVD neuroimaging markers, although it is mainly derived from small studies in heterogeneous populations . We sought to explore the aforementioned hypothesis in a comprehensive systematic review of published literature.…”

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

“…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].…”

Cerebral ischemia during hemodialysis—finding the signal in the noise

“…Cognitive impairment and white matter abnormalities are independently associated with renal impairment in a dose‐related fashion . In addition, albuminuria is associated with cerebral white matter abnormalities and cognitive impairment independently of eGFR . Conversely, some investigators have found that hemodialysis can be associated with improved cognitive performance, presumably by virtue of clearing uraemic toxins .…”

“…[10][11][12][13] In addition, albuminuria is associated with cerebral white matter abnormalities and cognitive impairment independently of eGFR. 12,14 Conversely, some investigators have found that hemodialysis can be associated with improved cognitive performance, presumably by virtue of clearing uraemic toxins. 15 Given this background, it is extremely difficult to isolate the impact of ischemic, osmotic and inflammatory insults derived from hemodialysis itself.…”