Kidney Function and Cognitive Impairment in US Adults: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study
Open accessAbstract
Background The association between kidney function and cognitive impairment has not been assessed in a national sample with a wide spectrum of kidney disease severity.Study design Cross-sectional.Setting & participants 23,405 participants (mean age, 64.9 +/- 9.6 years) with baseline measurements of creatinine and cognitive function participating in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study, a study of stroke risk factors in a large national sample.Predictor Estimated glomerular filtration rate (eGFR).Outcome Cognitive impairment.Measurements Chronic kidney disease (CKD) was defined as eGFR less than 60 mL/min/1.73 m(2). Kidney function was analyzed in 10-mL/min/1.73 m(2) increments in those with CKD, and in exploratory analyses, across the range of kidney function. Cognitive function was assessed using the 6-Item Screener, and participants with a score of 4 or less were considered to have cognitive impairment.Results CKD was associated with an increased prevalence of cognitive impairment independent of confounding factors (odds ratio, 1.23; 95% confidence interval, 1.06 to 1.43). In patients with CKD, each 10-mL/min/1.73 m(2) decrease in eGFR less than 60 mL/min/1.73 m(2) was associated with an 11% increased prevalence of impairment (odds ratio, 1.11; 95% confidence interval, 1.04 to 1.19). Exploratory analyses showed a nonlinear association between eGFR and prevalence of cognitive impairment, with a significant increased prevalence of impairment in those with eGFR less than 50 and 100 mL/min/1.73 m(2) or greater.Limitations Longitudinal measures of cognitive function were not available.Conclusions In US adults, lower levels of kidney function are associated with an increased prevalence of cognitive impairment. The prevalence of impairment appears to increase early in the course of kidney disease; therefore, screening for impairment should be considered in all adults with CKD.
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In cross-sectional and longitudinal studies, each 10 ml/min/1.73 m2 reduction in estimated GFR below 60 ml/min/1.73 m2 is associated with an approximately 11% increase in prevalence of cognitive impairment.
“In cross-sectional and longitudinal studies, each 10 ml/min/1.73 m2 reduction in estimated GFR (eGFR) below 60 ml/min/1.73 m2 was associated with an approximately 11% increase in the prevalence of cognitive impairment177,178.”
From The gut microbiota and the brain–gut–kidney axis in hypertension and chronic kidney disease (2018) · cites this paper as [178]
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- Authors
- Kurella Tamura, M., Wadley, V., Yaffe, K., McClure, L. A., Howard, G., Go, R., Allman, R. M., Warnock, D. G., & McClellan, W.
- Affiliations
- University of Alabama at Birmingham (US)
- University of California, San Francisco (US)
- Emory University (US)
- ORCID
- Venue
- American Journal of Kidney Diseases
- Publisher
- Elsevier BV
- Published
- 2008-08
- Volume
- 52
- Issue
- 2
- Pages
- 227-234
- ISSN
- 0272-6386 (ISSN-L)
- PMC
- PMC2593146
- OpenAlex
- W1976448779
- Cited by
- 388
- References
- 22
- Citations by year
- 2026: 10 · 2025: 25 · 2024: 25 · 2023: 21 · 2022: 26 · 2021: 16 · 2020: 23 · 2019: 22 · 2018: 28 · 2017: 15 · 2016: 22 · 2015: 19 · 2014: 23 · 2013: 19 · 2012: 21
- FWCI
- 17.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Kidney Diseases (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Health and Human Services (U01NS041588)
- Amgen
- Wake Forest University
- University of Arkansas for Medical Sciences
- National Institutes of Health ((U01 NS041588, NS041588)
- National Heart, Lung, and Blood Institute (R01HL080477)
- National Institute of Neurological Disorders and Stroke (U01NS041588, NS 041588)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Keywords
- chronic kidney disease, cognitive impairment, estimated glomerular filtration rate, renal function, creatinine, nonlinear relationship, cognitive screening, REGARDS study, stroke risk factors
- MeSH terms
- Adult, Cognition, Cognition Disorders, Glomerular Filtration Rate, Humans, Kidney Failure, Chronic, United States, Incidence, Topography, Medical, Stroke, Racial Groups
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