Kidney function changes and their relation with the progression of cerebral small vessel disease and cognitive decline.
Aged
Albuminuria
/ diagnostic imaging
Cerebral Small Vessel Diseases
/ diagnostic imaging
Cognitive Dysfunction
/ diagnostic imaging
Disease Progression
Female
Follow-Up Studies
Glomerular Filtration Rate
/ physiology
Humans
Kidney
/ diagnostic imaging
Longitudinal Studies
Male
Middle Aged
Risk Factors
Cerebral small vessel disease
Hypertension
Kidney function
Longitudinal study
MCI (mild cognitive impairment)
Journal
Journal of the neurological sciences
ISSN: 1878-5883
Titre abrégé: J Neurol Sci
Pays: Netherlands
ID NLM: 0375403
Informations de publication
Date de publication:
15 Feb 2020
15 Feb 2020
Historique:
received:
03
10
2019
revised:
27
11
2019
accepted:
12
12
2019
pubmed:
24
12
2019
medline:
20
3
2021
entrez:
24
12
2019
Statut:
ppublish
Résumé
We aimed to study whether worsening in markers of kidney function parallels the progression in cerebral small vessel disease (cSVD) and cognitive decline. Data from the ISSYS (Investigating Silent Strokes in Hypertensives Study), a longitudinal population-based study in hypertensives aged 50-70 and dementia and stroke-free at baseline. At both visits, patients underwent a brain MRI, a cognitive diagnosis (normal aging or mild cognitive impairment, [MCI]) and urine and blood sampling collection. We assessed the incidence of infarcts and cerebral microbleeds, and the progression of white matter hyperintensities at periventricular (PVH) and deep areas. We determined changes in albumin-creatinine ratio and estimated glomerular filtration rate (eGFR). These changes were dichotomized into microalbuminuria at follow-up -either in subjects with or without baseline microalbuminuria- and significant decline in eGFR -lowest quintile of eGFR change (-10.57 mL/min/1.73m 360 patients were followed-up for 4 years. 80 (23%) patients presented microalbuminuria at follow-up and 68 (20.1%) experienced a significant eGFR decline. Considering cSVD change, we found a relationship between microalbuminuria at follow-up and progression in PVH (β = 0.31, P-value = .01). Regarding cognitive decline, presence of microalbuminuria at follow-up related to a steeper decrease in memory function (β = -0.36, P-value<.01). Moreover, patients with significant decline in eGFR were at higher risk of incident MCI (OR = 3.54, P-value = .02). These associations were independent of progression of cSVD. The worsening in markers of kidney function paralleled the decrease in cognition and the progression of cSVD, and this may be explained by common shared underlying risk factors.
Identifiants
pubmed: 31869590
pii: S0022-510X(19)32400-1
doi: 10.1016/j.jns.2019.116635
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
116635Informations de copyright
Copyright © 2019. Published by Elsevier B.V.
Déclaration de conflit d'intérêts
Declaration of Competing Interest We declare no conflicts of interest.