Cognitive Performance Is Highly Stable over a 2-Year-Follow-Up in Chronic Kidney Disease Patients in a Dedicated Medical Environment.
BACKGROUND
As kidney and brain functions decline with aging, chronic kidney disease (CKD) and dementia are becoming increasing health burdens worldwide. Among the risk factors for cognitive impairment, CKD is increasingly recognized. The precise impact of CKD on the development of cognitive impairment is poorly understood.


METHODS
In the New Tools for the Prevention of Cardiovascular Disease in Chronic Kidney Disease (NTCVD) cohort, which was recruited in a dedicated nephrology department, we examined the 2-year course of cognitive performance in 120 patients (73 patients with CKD stages 3-5D, 47 control patients without CKD with similar vascular risk profile) using a comprehensive battery of 10 neuropsychological tests.


RESULTS
Kidney function, vascular risk factors and cognitive performance were highly stable both in CKD and control patients. The summary score of cognitive performance in CKD patients was very similar at baseline (z = -0.63±0.76) and follow-up (z = -0.54±0.79, p = 0.113), as was cognitive performance in control patients (z = -0.01±0.59 and 0.01±0.70, p = 0.862, at baseline and follow-up, respectively). Total serum cholesterol (199.6±36.0 and 186.0±32.9, p = 0.005 in controls; 194.4±46.1 and 181.2±41.2, p = 0.008 in CKD) and common carotid intima-media thickness (0.87±0.18 and 0.84±0.17, p = 0.351 in controls; 0.88±0.21 and 0.82±0.16, p = 0.002 in CKD) moderately but significantly decreased during the follow-up. In multivariable regression analyses, high age (β = -0.28, 95%CI = -0.48 to 0.08, p = 0.007) predicted decrease in cognitive performance.


CONCLUSIONS
In this well-defined cohort receiving state-of-the-art therapy, cognitive performance did not decrease over 2 years. Our data emphasize the aspect of risk factor control, suggesting that dedicated medical care might prevent cognitive decline in CKD patients.
Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Janine
J
Gronewold
Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Olga
O
Todica
Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Ulla K
UK
Seidel
Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Michaela
M
Volsek
Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Andreas
A
Kribben
Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Heike
H
Bruck
Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Dirk M
DM
Hermann
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D003071:Cognition / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000503:physiopathology / Q000523:psychology*; D012720:Severity of Illness Index
D002784:Cholesterol