Mild chronic kidney disease is associated with cognitive function in patients presenting at a memory clinic. (4th November 2014)

• Record Type: Journal Article
• Authors: Romijn, Marloes D.M.; van Marum, Rob J.; Emmelot‐Vonk, Mariëlle H.; Verhaar, Harald J.J.; Koek, Huiberdina L.
• Is Part Of: International journal of geriatric psychiatry. Volume 30:Number 7(2015:Jul.)
• Page Start: 758
• Page End: 765
• Publication Date: 2014-11-04
• Subjects: Geriatric psychiatry -- Periodicals; Geriatric Psychiatry -- Periodicals; 618.97689
• DOI: 10.1002/gps.4226
• Languages: English
• ISSNs: 0885-6230

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="gps4226-sec-0001" sec-type="section"> <title>Objective</title> <p>In dialysis‐dependent and severe chronic kidney disease (CKD) patients, cognitive impairment is found in 16–29%. In community‐dwelling population without dementia mixed results have been observed. We investigated the relationship between renal function and cognition in patients from a memory clinic.</p> </sec> <sec id="gps4226-sec-0002" sec-type="section"> <title>Methods</title> <p>We performed a cross‐sectional study of consecutive patients from a memory clinic between 2005 and 2009. Renal function was estimated with the Modification of Diet in Renal Diseases (MDRD) and Cockcroft‐Gault (CG) formulas, and categorized into ordinal groups: reference ≥60 ml/min/1.73 m<sup>2</sup>, mild CKD 45–59 ml/min/1.73 m<sup>2</sup> and moderate CKD <45 ml/min/1.73 m<sup>2</sup>. Cognitive function was dichotomized (Mini‐Mental State Examination (MMSE) ≥24 vs. <24). We performed multiple logistic regression analyses with adjustment for potential confounders.</p> </sec> <sec id="gps4226-sec-0003" sec-type="section"> <title>Results</title> <p>The cohort comprised 581 patients (mean age 77 ± 10 years). With the MDRD, there were 74 (12%) cases with moderate CKD and 108 (18%) with mild CKD. With the CG, these prevalences were 144 (30%) and 130 (27%). In mild CKD patients, a significant relationship was found between cognitive function and CKD according to the MDRD‐formula [adjusted OR 2.10; 95%CI 1.09–4.05]. In moderate CKD patients, no significant adjusted associations were found. In patients without dementia, significant adjusted associations were found between CKD and MMSE (MDRD: mild CKD [OR 5.09; 95%CI 1.17–22.14] and moderate CKD [OR 5.03; 95%CI 1.10–22.98]; CG: mild CKD [OR 6.16; 95%CI 1.17–32.50] and moderate CKD [OR 5.60; 95%CI 1.01–30.91]).</p> </sec> <sec id="gps4226-sec-0004" sec-type="section"> <title>Conclusion</title> <p>This study showed a significant association between mild CKD and impaired cognitive function in patients from a memory clinic, especially in patients without dementia. Copyright © 2014 John Wiley & Sons, Ltd.</p> </sec> </abstract>