Worsening Renal Function is a Risk Factor for Incident Dementia

Pavankumar Kamat

Disclosures

January 11, 2022

Takeaway

  • Reduced estimated glomerular filtration rate (eGFR) and elevated urine albumin creatinine ratio (ACR) were associated with a higher risk of all-cause dementia.

Why this matters

  • Further research is needed to determine whether good chronic kidney disease (CKD) care reduces dementia risk and whether active surveillance for signs of early dementia is recommended in patients with CKD.

Study design

  • A retrospective cohort study included 2,797,384 patients with serum creatinine (eGFR cohort) and 641,912 with urine ACR (ACR cohort), identified from the UK IQVIA Medical Research Data-The Health Improvement Network (1995-2020).

  • The associations between different eGFR categories (G1-G5) and urine ACR (A1-A3) categories and incident all-cause dementia were evaluated.

  • Funding: None.

Key results

  • In the eGFR cohort, the risk of all-cause dementia significantly increased with worsening eGFR categories (adjusted HR [aHR]; 95% CI):

    • G2 (eGFR 60-89 mL/min/1.73m2): 1.15; 1.11 to 1.18;

    • G3a (eGFR 45-59 mL/min/1.73m2): 1.18; 1.14 to 1.22;

    • G3b (eGFR 30-44 mL/min/1.73m2): 1.22; 1.17 to 1.26; and

    • G4 (eGFR 15-29 mL/min/1.73m2): 1.26; 1.19 to 1.33; P < 0.001 for all.

  • The G5 category (eGFR <15 mL/min/1.73m2) was not significantly associated with a higher risk of all-cause dementia (aHR, 1.06; 95% CI, 0.89 to 1.26; P = 0.522).

  • In the ACR cohort, the risk of all-cause dementia significantly increased across different ACR categories (aHR; 95% CI):

    • A2 (ACR 3-30 mg/mmoL): 1.13; 1.10 to 1.15; and

    • A3 (ACR >30 mg/mmoL): 1.25; 1.18 to 1.33; P < 0.001 for both.

Limitations

  • Retrospective design.

Lee SI, Cooper J, Fenton A, Subramanian A, Taverner T, Gokhale KM, Phillips K, Patel M, Harper L, Thomas GN, Nirantharakumar K. Decreased renal function is associated with incident dementia: An IMRD-THIN retrospective cohort study in the UK. Alzheimers Dement. 2022 Jan 03 [Epub ahead of print]. doi: 10.1002/alz.12539. PMID: 34978143 View abstract.

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