Decline in renal functioning is associated with longitudinal decline in global cognitive functioning, abstract reasoning and verbal memory

Davey, Adam; Elias, Merrill F.; Robbins, Michael A.; Seliger, Stephen L.; Dore, Gregory A.

doi:10.1093/ndt/gfs470

Cited by 96 publications

(99 citation statements)

References 52 publications

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“…In our study, there was a trend for a 1 ml/min per 1.73 m 2 per year eGFR decline (approximately double the median annual eGFR decline) to be associated with lower DSST scores in the cohort. Two population-based studies with unimpaired renal function and a low prevalence of diabetes reported that only an eGFR decline of .3-4 ml/min per 1.73 m 2 per year was significantly associated with cognitive decline (5,42).…”

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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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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“…Many studies have shown a progressive decline in cognitive functions with progressive renal failure (Kurella et al 2005b;Davey et al 2013). Emotional changes, anxiety and depression have also been reported in cases of chronic renal failure (Montinaro et al 2010).…”

Section: Locomotor Exploratory and Emotional Activitymentioning

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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“…In line with this, Davey et al [23] could not show an association between baseline eGFR as indicator of kidney function and change in cognitive function also assessed with a comprehensive neuropsychological test battery at baseline and 5-years follow-up, but between decreases in eGFR and decreases in cognitive performance, with about 37% of CKD patients experiencing a clinically relevant deterioration of eGFR defined by >3 mL/min/1.73 m²/year, which was twice the frequency observed in the NT CVD cohort. Also in accordance with this finding of high relevance of tight control of kidney function and CKD-associated risk factors and diseases for the prevention of progression of cognitive deficits is the positive effect of dialysis and transplantation therapy on cognition [24].…”

Section: Introductionmentioning

confidence: 67%

Cognitive Impairment in Chronic Kidney Disease-Prevalence, Mechanisms and Consequences

Gronewold¹,

Hermann²

2017

J Alzheimers Dis Parkinsonism

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Decline in renal functioning is associated with longitudinal decline in global cognitive functioning, abstract reasoning and verbal memory

Abstract: Early detection of mild to moderate kidney disease is an important public health concern with regard to cognitive decline.

Cited by 96 publications

References 52 publications

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

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

Psychomotor functions at various weeks of chronic renal failure in rats

Cognitive Impairment in Chronic Kidney Disease-Prevalence, Mechanisms and Consequences

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