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• W2897715439 abstract "Although the graded association between renal and cognitive function is well-recognized, the effect of renal-associated factors beyond estimated glomerular filtration rate (eGFR, in mL/min/1.73 m2) and urinary albumin creatinine ratio (UACR, in mg/g) in chronic kidney disease (CKD) patients is unclear. We sought to identify renal metabolic factors associated with prevalent moderate to severe cognitive impairment (mod/sev CI) in CKD participants in the BRain IN Kidney disease (BRINK) study. Participants were ≥ 45 years old with moderate/severe (non-dialysis) CKD (eGFR) < 60) in Minneapolis/St. Paul. Metabolic measures obtained at baseline included serum phosphorus, calcium, cystatin C, TNFαR1, F-2 isoprostane (oxidative stress), PTH, hemoglobin and hgbA1c. Logistic regression models for mod/sev CI were run with metabolic factors, adjusted for demographics and comorbidities. Neuropsychological testing was performed using the 3MS, the Hopkins Verbal Learning Test-Revised and Brief Visuospatial Memory Test-Revised (memory); Color Trails 1 and 2, Symbol-Digit-Modalities Test (executive function), and Controlled Oral Word Association Test and animal naming (language). Among 433 CKD participants at baseline, (Table 1) mean age was 70 years, mean education 14 years; 16% were non- white; mean (SD) eGFR was 34.3 (11.8). After adjusting for renal function and cardiovascular comorbidities, serum phosphorus ≥ 4.0 mg/dL (mean 3.6) was associated with mod/sev CI among those with mild/moderate CKD (eGFR 30 - < 60); OR [95% CI] of 2.59 [1.16-5.79)]; P=0.020, whereas elevated TNFaR1 (mean 3598 pg/mL), was significant in both all CKD; OR =1.39, [1.08,1.79], P =0.010 and eGFR 30 - < 60 group,1.52 [1.12, 2.05]; P = 0.007 . Phosphorus ≥ 4.0 and increased inflammation (TNFaR1) are potentially modifiable risk factors for mod/sev CI in mild/moderate CKD patients, the most common CKD group in the US, with prevalence of > 3 million. High phosphorus may contribute to CI through impaired cerebral vascular endothelial function and relaxation and increased vascular calcification. Initiation of phosphate binders at lower levels of serum phosphorus than current recommended guidelines, and novel anti-inflammatory agents are possible interventions to delay cognitive decline in CKD." @default.
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• W2897715439 date "2018-07-01" @default.
• W2897715439 modified "2023-10-16" @default.
• W2897715439 title "P2‐280: METABOLIC FACTORS ASSOCIATED WITH MODERATE TO SEVERE COGNITIVE IMPAIRMENT IN CHRONIC KIDNEY DISEASE" @default.
• W2897715439 doi "https://doi.org/10.1016/j.jalz.2018.06.969" @default.
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