Minneapolis-Chronic kidney disease is when a person's kidneys gradually lose their ability to filter waste and remove body fluids from the blood. A new study now finds that people with reduced kidney function may have an increased risk of dementia. The research was published in the online version of Neurology® (a medical journal of the American Academy of Neurology) on May 5, 2021.
In the United States, chronic kidney disease affects approximately 15% of adults, and it becomes more common with age. However, because many people do not develop symptoms until late, it is estimated that 90% of chronic kidney disease patients do not know that they have the disease.
"Even a slight decline in kidney function is associated with an increased risk of cardiovascular disease and infection, and there is increasing evidence that there is a connection between the kidney and the brain," said study author Dr. Hong Xu, Carolins, Stockholm, Sweden Card academy. "Just like chronic kidney disease, the risk of dementia increases with age. Since there are no effective treatments to slow or prevent dementia, it is important to identify possible changeable risk factors. If we can prevent or delay Certain cases of dementia treat kidney disease, which may be beneficial to public health. Our research shows that decreased kidney function is related to the development of dementia, but we cannot prove that this is a cause."
In this study, researchers used a database to identify nearly 330,000 people 65 years and older who received medical care in the city of Stockholm and were followed up for an average of 5 years. At the beginning of the study, none of the participants had dementia or had received a kidney transplant or dialysis. During the study, 18,983 people (6% of the participants) were diagnosed with dementia.
Creatinine is a waste product of muscles, which is removed from the blood by the kidneys and released into the urine. Using a blood test for plasma creatinine, the researchers estimated the glomerular filtration rate of each participant, which is a measure of the degree to which the blood is filtered by the kidneys and is usually used to approximate kidney function. In most healthy people, an estimated filtration rate of 90 milliliters per minute (mL) or higher is considered normal.
The researchers then used this method to determine the incidence of dementia in people with different levels of kidney function. They use person years to calculate the difference. Person-year takes into account the number of people in the study and the time each person spends in the study.
Researchers found that as kidney function declines, the incidence of dementia increases. In people with a normal renal filtration rate of 90 to 104 milliliters per minute, there are 7 cases of dementia per 1,000 person-years. In people with severe kidney disease or with a filtration rate of less than 30 milliliters per minute, there are 30 cases of dementia per 1,000 person-years.
After adjusting for other factors that may affect the risk of dementia (such as smoking, drinking, high blood pressure, and diabetes), the researchers determined that people with a filtration rate of 30 to 59 milliliters per minute (indicating moderate chronic kidney disease) suffer from dementia. The risk is 71% higher. Compared with people with normal kidney function and a filtration rate of less than 30 mL/min, the risk of dementia is 162% higher.
The researchers also checked the data of 205,622 participants who underwent multiple blood tests within a year. They use these tests to estimate the rate of decline in kidney function. They found that during this period of time, a person's filtration rate dropped sharply and was also related to a higher risk of being diagnosed with dementia in the future.
According to researchers, 10% of dementia cases can be attributed to a filtration rate of 60 milliliters per minute or less, which is higher than the proportion of dementia cases attributed to other dementia risk factors such as cardiovascular disease and diabetes.
"Our study identified chronic kidney disease as a possible risk factor for dementia, and although it showed a correlation, it did not prove that it was a cause," Xu said. "More research is needed to determine the exact cause of this association. However, our findings raise awareness of the connection between these two conditions and may help health professionals develop and implement strategies to screen for kidney disease. , And monitor the kidney function of people at risk of kidney disease. Dementia. Early detection and treatment of cases may reduce the risk of dementia.”
The limitation of this study is that dementia is confirmed by clinical diagnosis. Accessing participants’ medical records may help identify more cases.
The research was supported by the Swedish Research Council and the Karolinska Institute.
Learn more about dementia on BrainandLife.org, the homepage of the free patient and caregiver journal of the American Academy of Neurology, focusing on the intersection of neurological diseases and brain health. Follow Brain & Life® on Facebook, Twitter and Instagram.
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