OBJECTIVES: To determine the association between cognition and levels of cystatin C in persons with chronic kidney disease (CKD). DESIGN: Prospective observational study. SETTING: Chronic Renal Insufficiency Cohort Cognitive Study. PARTICIPANTS: Individuals with a baseline cognitive assessment completed at the same visit as serum cystatin C measurement (N = 821; mean age 64.9, 50.6% male, 48.6% white). MEASUREMENTS: Levels of serum cystatin C were categorized into tertiles; cognitive function was assessed using six neuropsychological tests. Scores on these tests were compared across tertiles of cystatin C using linear regression and logistic regression to examine the association between cystatin C level and cognitive performance (1 standard deviation difference from the mean). RESULTS: After multivariable adjustment for age, race, education, and medical comorbidities in linear models, higher levels of cystatin C were associated with worse cognition on the modified Mini-Mental State Examination, Buschke Delayed Recall, Trail-Making Test Part (Trails) A and Part B, and Boston Naming (P < .05 for all). This association remained statistically significant for Buschke Delayed Recall (P = .01) and Trails A (P = .03) after additional adjustment for estimated glomerular filtration rate (eGFR). The highest tertile of cystatin C was associated with greater likelihood of poor performance on Trails A (odds ratio (OR) = 2.17, 95% confidence interval (CI) = 1.16-4.06), Trails B (OR = 1.89, 95% CI = 1.09-3.27), and Boston Naming (OR = 1.85, 95% CI = 1.07-3.19) than the lowest tertile after multivariate adjustment in logistic models. CONCLUSION: In individuals with CKD, higher serum cystatin C levels were associated with worse cognition and greater likelihood of poor cognitive performance on attention, executive function, and naming. Cystatin C is a marker of cognitive impairment and may be associated with cognition independent of eGFR.
OBJECTIVES: To determine the association between cognition and levels of cystatin C in persons with chronic kidney disease (CKD). DESIGN: Prospective observational study. SETTING:Chronic Renal Insufficiency Cohort Cognitive Study. PARTICIPANTS: Individuals with a baseline cognitive assessment completed at the same visit as serum cystatin C measurement (N = 821; mean age 64.9, 50.6% male, 48.6% white). MEASUREMENTS: Levels of serum cystatin C were categorized into tertiles; cognitive function was assessed using six neuropsychological tests. Scores on these tests were compared across tertiles of cystatin C using linear regression and logistic regression to examine the association between cystatin C level and cognitive performance (1 standard deviation difference from the mean). RESULTS: After multivariable adjustment for age, race, education, and medical comorbidities in linear models, higher levels of cystatin C were associated with worse cognition on the modified Mini-Mental State Examination, Buschke Delayed Recall, Trail-Making Test Part (Trails) A and Part B, and Boston Naming (P < .05 for all). This association remained statistically significant for Buschke Delayed Recall (P = .01) and Trails A (P = .03) after additional adjustment for estimated glomerular filtration rate (eGFR). The highest tertile of cystatin C was associated with greater likelihood of poor performance on Trails A (odds ratio (OR) = 2.17, 95% confidence interval (CI) = 1.16-4.06), Trails B (OR = 1.89, 95% CI = 1.09-3.27), and Boston Naming (OR = 1.85, 95% CI = 1.07-3.19) than the lowest tertile after multivariate adjustment in logistic models. CONCLUSION: In individuals with CKD, higher serum cystatin C levels were associated with worse cognition and greater likelihood of poor cognitive performance on attention, executive function, and naming. Cystatin C is a marker of cognitive impairment and may be associated with cognition independent of eGFR.
Authors: Nrupen A Bhavsar; Lawrence J Appel; John W Kusek; Gabriel Contreras; George Bakris; Josef Coresh; Brad C Astor Journal: Am J Kidney Dis Date: 2011-09-22 Impact factor: 8.860
Authors: Carmen A Peralta; Michael G Shlipak; Suzanne Judd; Mary Cushman; William McClellan; Neil A Zakai; Monika M Safford; Xiao Zhang; Paul Muntner; David Warnock Journal: JAMA Date: 2011-04-11 Impact factor: 56.272
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: J Sundelöf; J Arnlöv; E Ingelsson; J Sundström; S Basu; B Zethelius; A Larsson; M C Irizarry; V Giedraitis; E Rönnemaa; M Degerman-Gunnarsson; B T Hyman; H Basun; L Kilander; L Lannfelt Journal: Neurology Date: 2008-09-30 Impact factor: 9.910
Authors: Priya Rajagopalan; Helga Refsum; Xue Hua; Arthur W Toga; Clifford R Jack; Michael W Weiner; Paul M Thompson Journal: Neurobiol Aging Date: 2012-11-20 Impact factor: 4.673
Authors: Vandana Menon; Michael G Shlipak; Xuelei Wang; Josef Coresh; Tom Greene; Lesley Stevens; John W Kusek; Gerald J Beck; Allan J Collins; Andrew S Levey; Mark J Sarnak Journal: Ann Intern Med Date: 2007-07-03 Impact factor: 25.391
Authors: Yelena Slinin; Katherine W Peters; Areef Ishani; Kristine Yaffe; Howard A Fink; Katie L Stone; Michael Steffes; Kristine E Ensrud Journal: J Gerontol A Biol Sci Med Sci Date: 2014-11-01 Impact factor: 6.053
Authors: Daniel E Weiner; Sarah A Gaussoin; John Nord; Alexander P Auchus; Gordon J Chelune; Michel Chonchol; Laura Coker; William E Haley; Anthony A Killeen; Paul L Kimmel; Alan J Lerner; Suzanne Oparil; Mohammad G Saklayen; Yelena M Slinin; Clinton B Wright; Jeff D Williamson; Manjula Kurella Tamura Journal: Am J Kidney Dis Date: 2017-06-09 Impact factor: 8.860
Authors: Ahmed Alaini; Deepak Malhotra; Helbert Rondon-Berrios; Christos P Argyropoulos; Zeid J Khitan; Dominic S C Raj; Mark Rohrscheib; Joseph I Shapiro; Antonios H Tzamaloukas Journal: World J Methodol Date: 2017-09-26