OBJECTIVES: To investigate cognitive impairment in older, ethnically diverse individuals with a broad range of kidney function, to evaluate a spectrum of cognitive domains, and to determine whether the relationship between chronic kidney disease (CKD) and cognitive function is independent of demographic and clinical factors. DESIGN: Cross-sectional. SETTING: Chronic Renal Insufficiency Cohort Study. PARTICIPANTS: Eight hundred twenty-five adults aged 55 and older with CKD. MEASUREMENTS: Estimated glomerular filtration rate (eGFR, mL/min per 1.73 m(2)) was estimated using the four-variable Modification of Diet in Renal Disease equation. Cognitive scores on six cognitive tests were compared across eGFR strata using linear regression; multivariable logistic regression was used to examine level of CKD and clinically significant cognitive impairment (score < or =1 standard deviations from the mean). RESULTS: Mean age of the participants was 64.9, 50.4% were male, and 44.5% were black. After multivariable adjustment, participants with lower eGFR had lower cognitive scores on most cognitive domains (P<.05). In addition, participants with advanced CKD (eGFR<30) were more likely to have clinically significant cognitive impairment on global cognition (adjusted odds ratio (AOR) 2.0, 95% CI=1.1-3.9), naming (AOR=1.9, 95% CI=1.0-3.3), attention (AOR=2.4, 95% CI=1.3-4.5), executive function (AOR=2.5, 95% CI=1.9-4.4), and delayed memory (AOR=1.5, 95% CI=0.9-2.6) but not on category fluency (AOR=1.1, 95% CI=0.6-2.0) than those with mild to moderate CKD (eGFR 45-59). CONCLUSION: In older adults with CKD, lower level of kidney function was associated with lower cognitive function on most domains. These results suggest that older patients with advanced CKD should be screened for cognitive impairment.
OBJECTIVES: To investigate cognitive impairment in older, ethnically diverse individuals with a broad range of kidney function, to evaluate a spectrum of cognitive domains, and to determine whether the relationship between chronic kidney disease (CKD) and cognitive function is independent of demographic and clinical factors. DESIGN: Cross-sectional. SETTING:Chronic Renal Insufficiency Cohort Study. PARTICIPANTS: Eight hundred twenty-five adults aged 55 and older with CKD. MEASUREMENTS: Estimated glomerular filtration rate (eGFR, mL/min per 1.73 m(2)) was estimated using the four-variable Modification of Diet in Renal Disease equation. Cognitive scores on six cognitive tests were compared across eGFR strata using linear regression; multivariable logistic regression was used to examine level of CKD and clinically significant cognitive impairment (score < or =1 standard deviations from the mean). RESULTS: Mean age of the participants was 64.9, 50.4% were male, and 44.5% were black. After multivariable adjustment, participants with lower eGFR had lower cognitive scores on most cognitive domains (P<.05). In addition, participants with advanced CKD (eGFR<30) were more likely to have clinically significant cognitive impairment on global cognition (adjusted odds ratio (AOR) 2.0, 95% CI=1.1-3.9), naming (AOR=1.9, 95% CI=1.0-3.3), attention (AOR=2.4, 95% CI=1.3-4.5), executive function (AOR=2.5, 95% CI=1.9-4.4), and delayed memory (AOR=1.5, 95% CI=0.9-2.6) but not on category fluency (AOR=1.1, 95% CI=0.6-2.0) than those with mild to moderate CKD (eGFR 45-59). CONCLUSION: In older adults with CKD, lower level of kidney function was associated with lower cognitive function on most domains. These results suggest that older patients with advanced CKD should be screened for cognitive impairment.
Authors: Sudha Seshadri; Alexa Beiser; Jacob Selhub; Paul F Jacques; Irwin H Rosenberg; Ralph B D'Agostino; Peter W F Wilson; Philip A Wolf Journal: N Engl J Med Date: 2002-02-14 Impact factor: 91.245
Authors: Josef Coresh; Brad C Astor; Geraldine McQuillan; John Kusek; Tom Greene; Frederick Van Lente; Andrew S Levey Journal: Am J Kidney Dis Date: 2002-05 Impact factor: 8.860
Authors: Stephen L Seliger; Daniel L Gillen; W T Longstreth; Bryan Kestenbaum; Catherine O Stehman-Breen Journal: Kidney Int Date: 2003-08 Impact factor: 10.612
Authors: Jerome L Abramson; Claudine T Jurkovitz; Viola Vaccarino; William S Weintraub; William McClellan Journal: Kidney Int Date: 2003-08 Impact factor: 10.612
Authors: Michael G Shlipak; Linda F Fried; Casey Crump; Anthony J Bleyer; Teri A Manolio; Russell P Tracy; Curt D Furberg; Bruce M Psaty Journal: Circulation Date: 2003-01-07 Impact factor: 29.690
Authors: Harold I Feldman; Lawrence J Appel; Glenn M Chertow; Denise Cifelli; Borut Cizman; John Daugirdas; Jeffrey C Fink; Eunice D Franklin-Becker; Alan S Go; L Lee Hamm; Jiang He; Tom Hostetter; Chi-Yuan Hsu; Kenneth Jamerson; Marshall Joffe; John W Kusek; J Richard Landis; James P Lash; Edgar R Miller; Emile R Mohler; Paul Muntner; Akinlolu O Ojo; Mahboob Rahman; Raymond R Townsend; Jackson T Wright Journal: J Am Soc Nephrol Date: 2003-07 Impact factor: 10.121
Authors: Laura C Plantinga; Kirsten Johansen; Deidra C Crews; Vahakn B Shahinian; Bruce M Robinson; Rajiv Saran; Nilka Ríos Burrows; Desmond E Williams; Neil R Powe Journal: Am J Kidney Dis Date: 2010-10-30 Impact factor: 8.860
Authors: Meera N Harhay; Dawei Xie; Xiaoming Zhang; Chi-Yuan Hsu; Eric Vittinghoff; Alan S Go; Stephen M Sozio; Jacob Blumenthal; Stephen Seliger; Jing Chen; Rajat Deo; Mirela Dobre; Sanjeev Akkina; Peter P Reese; James P Lash; Kristine Yaffe; Manjula Kurella Tamura Journal: Am J Kidney Dis Date: 2018-05-02 Impact factor: 8.860
Authors: Mara A McAdams-DeMarco; Jingwen Tan; Megan L Salter; Alden Gross; Lucy A Meoni; Bernard G Jaar; Wen-Hong Linda Kao; Rulan S Parekh; Dorry L Segev; Stephen M Sozio Journal: Clin J Am Soc Nephrol Date: 2015-11-16 Impact factor: 8.237