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Kidney function and cognitive decline in an oldest-old Chinese population

Authors Bai K, Pan Y, Lu F, Zhao Y, Wang J, Zhang L

Received 8 February 2017

Accepted for publication 26 May 2017

Published 4 July 2017 Volume 2017:12 Pages 1049—1054


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Zhi-Ying Wu

Kunhao Bai,1,2,* Yujing Pan,3,* Fanghong Lu,4 Yingxin Zhao,4 Jinwei Wang,1,2 Luxia Zhang1,2

1Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People’s Republic of China; 2Peking University Institute of Nephrology, Peking University Health Science Center, Beijing, People’s Republic of China; 3Renal Division, Department of Medicine, Peking University International Hospital, Beijing, People’s Republic of China; 4Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, People’s Republic of China

*These authors contributed equally to this work

Background: Early-stage chronic kidney disease has been suggested to be correlated with cognitive decline, but the association has rarely been explored in the oldest old.
Subjects and methods: This prospective study included 284 Chinese participants aged 80 years or older with serum creatinine levels <150 µmol/L. The median follow-up time was 3.3 years, and 247 (87.0%) participants provided valid data at their last visit. Kidney function was evaluated by measuring the estimated glomerular filtration rate (eGFR) at baseline, and cognitive function was evaluated using the Mini-Mental State Examination (MMSE) at both baseline and annual visits. A reliable decrease in the MMSE score over the follow-up period was observed based on a Reliable Change Index of 1.645 (equivalent to a 90% confidence interval [CI]), which was used to define cognitive decline. Poisson regression models were built to analyze the association between baseline kidney function and cognitive decline.
Results: A total of 18 (7.3%) cases of incident cognitive decline were observed during the follow-up period. After adjusting for potential confounders, the relative risk of developing cognitive decline was 4.03 (95% CI 1.09–13.81) among participants with an eGFR of 30–59 mL/min/1.73 m2 compared to participants with an eGFR of ≥60 mL/min/1.73 m2.
Conclusion: Early-stage chronic kidney disease was correlated with cognitive decline in an oldest-old Chinese population.

Keywords: chronic kidney disease, cognitive decline, oldest old

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