title: Mild chronic kidney disease is associated with cognitive function in patients presenting at a memory clinic.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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(2), mild CKD 45-59 ml/min/1.73 m(2) and moderate CKD <45 ml/min/1.73 m(2). Cognitive function was dichotomized (Mini-Mental State Examination (MMSE) ≥ 24 vs. <24). We performed multiple logistic regression analyses with adjustment for potential confounders.
  
  
  RESULTS
  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]).
  
  
  CONCLUSIONS
  This study showed a significant association between mild CKD and impaired cognitive function in patients from a memory clinic, especially in patients without dementia.
authors.affiliation: Department of Geriatric Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.|Department of Geriatrics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
authors.forename: Marloes D M
authors.initials: MD
authors.lastname: Romijn
authors.affiliation: Department of Geriatrics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
authors.forename: Rob J
authors.initials: RJ
authors.lastname: van Marum
authors.affiliation: Department of Geriatric Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Mariëlle H
authors.initials: MH
authors.lastname: Emmelot-Vonk
authors.affiliation: Department of Geriatric Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Harald J J
authors.initials: HJ
authors.lastname: Verhaar
authors.affiliation: Department of Geriatric Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Huiberdina L
authors.initials: HL
authors.lastname: Koek
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology*; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D012189:Retrospective Studies
chemical_list: D003404:Creatinine
keywords: chronic kidney disease; cognition; dementia; memory clinic