title: Renal function affects hippocampal volume and cognition: The role of vascular burden and amyloid deposition.
abstract: OBJECTIVE
  We determined if differences in renal function, even within normal levels, influenced hippocampal volume (HCV) and cognition.
  
  
  METHODS
  Cognitively normal (CN) and mild cognitive impairment (MCI) subjects with eGFR ≥ 60 ml/min/1.73m2were selected from the ADNI database (N = 1,269) and divided into three groups (eGFR 60-75, 75-90 and ≥90). Associations between eGFR, HCV and cognition scores were examined using regression methods, and random-coefficient models. The relationship between various factors, such as vascular burden and brain amyloid deposition, were investigated using path analysis.
  
  
  RESULTS
  Higher eGFR was associated with larger HCVs and better cognition in all subjects at baseline. In MCI subjects, hippocampal atrophy in the eGFR ≥ 90 group progressed at just half the rate of the eGFR 75-90 group (P = .006), and was also somewhat slower than the eGFR 60-75 group (P = .08). A comprehensive path model linking eGFR, HCV and cognition, and integrating vascular burden and amyloid deposition, is proposed.
  
  
  CONCLUSIONS
  Higher renal function was associated with slower hippocampal atrophy and cognitive decline even within normal levels of renal function. This relationship was mediated mainly through cardiovascular risk burden and amyloid deposition. Further studies examining neuroinflammation are needed. Geriatr Gerontol Int 2017; 17: 1899-1906.
authors.affiliation: National Institute of Dementia, Seongnam, South Korea.|Department of Psychiatry, Seoul National, University Bundang Hospital, Seongnam, South Korea.
authors.forename: Hoyoung
authors.identifier: http://orcid.org/0000-0003-4249-4611
authors.initials: H
authors.lastname: An
authors.affiliation: Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Booyeol
authors.initials: B
authors.lastname: Choi
authors.affiliation: Department of Psychiatry, Ajou University Hospital, Ajou University, School of Medicine, Suwon, South Korea.
authors.forename: Sang Joon
authors.initials: SJ
authors.lastname: Son
authors.affiliation: Department of Biostatistics, Korea University Graduate School, Seoul, South Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Cho
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Seon-Ok
authors.initials: SO
authors.lastname: Kim
authors.affiliation: Clinical Neuroscience Lab, Department of Psychology, Seoul National University, Seoul, South Korea.
authors.forename: Sooyun
authors.initials: S
authors.lastname: Cho
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Ewha Woman's University, College of Medicine, Ewha Woman's University Mokdong Hospital, Seoul, South Korea.
authors.forename: Duk-Hee
authors.initials: DH
authors.lastname: Kang
authors.affiliation: Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Chul
authors.initials: C
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Seong Yoon
authors.initials: SY
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000682:Amyloid / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003072:Cognition Disorders / Q000453:epidemiology*; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D007668:Kidney / Q000502:physiology*; D008875:Middle Aged; D009929:Organ Size; D012306:Risk
chemical_list: D000682:Amyloid
keywords: dementia; glomerular filtration rate; hippocampus; kidney; vascular burden