Research shows that people living with chronic kidney disease (CKD) are at greater risk of cognitive decline, and the more advanced the CKD, the more severe the cognitive decline.

Most of those studies, however, focused on vascular issues as the cause. A more recent study investigated a different causal relationship between CKD and cognitive impairment, with visible structural abnormalities in the brain. Learn more here.*

What the researchers did

For the newer study, which was published in the American Journal of Kidney Diseases, the research team conducted a cross-sectional analysis of 1527 participants:

• 76.4 years was the average age 
• 57.6% were women 
• 27.3% were Black

According to the cognitive assessment:

• 60.6% (926) of the participants had no cognitive impairment, 
• 34.4% (525) had mild impairment, and 
• 5.0% (76) had dementia.

The team looked specifically at the relationship between estimated GFR (eGFR) and urinary albumin-creatinine ratio (UACR) with structural brain abnormalities visible on magnetic resonance imaging (MRI) scans.

What they found

The data revealed several outcomes indicating a link between lower eGFR and a higher prevalence of:

• High blood pressure
• Diabetes,
• Heart failure, and
• Personal history of stroke.

The study also found associations between:

• An eGFR of less than 30 and brain cortex atrophy 
• An eGFR of less than 30 and higher levels of albuminuria (excess levels of the protein albumin in the urine)
• Higher levels of albuminuria and lower brain volume

Participants with lower eGFRs and higher levels of albuminuria were also more likely to have brain infarcts (impeded blood flow) and micro-hemorrhages (small ruptures of blood vessels). 

The association between decreased eGFR with brain atrophy notably pointed to regions of the cerebral cortex usually involved in neurodegenerative diseases. 

What it means

The results were limited by the researchers’ inability to monitor the rate of brain atrophy over time, but the study “builds upon previous reports, which linked kidney function measures to dementia and cognitive decline and confirms the association of UACR and eGFR with structural brain damage,” according to the authors. In short, the lower the kidney function, the higher the risk of brain atrophy and cognitive impairment. 

Working closely with your nephrologist, renal dietitian, dialysis nurse, and collective healthcare team can help mitigate the risk of cognitive decline from CKD.

*Socha, V. (2024, March 18). Kidney Function Measures and Dementia and Cognitive Decline. DocWire News.https://www.docwirenews.com/post/kidney-function-measures-and-dementia-and-cognitive-decline  

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