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. 2016 Nov 11;11(11):e0166530.
doi: 10.1371/journal.pone.0166530. eCollection 2016.

Cognitive Performance Is Highly Stable over a 2-Year-Follow-Up in Chronic Kidney Disease Patients in a Dedicated Medical Environment

Janine Gronewold  1 , Olga Todica  1 , Ulla K Seidel  1 , Michaela Volsek  2 , Andreas Kribben  2 , Heike Bruck  2 , Dirk M Hermann  1
Affiliations

Cognitive Performance Is Highly Stable over a 2-Year-Follow-Up in Chronic Kidney Disease Patients in a Dedicated Medical Environment

Janine Gronewold et al. PLoS One. .

Abstract

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.

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Conflict of interest statement

Heike Bruck received lecture fees from Baxter Deutschland GmbH., but this does not alter our adherence to PLOS ONE policies on sharing data and materials. All other authors report no disclosures.

Figures

Fig 1
Fig 1. Flow chart of the NTCVD 2-year follow-up study.
Numbers of patients included and excluded in the follow-up analysis are shown. CKD, chronic kidney disease. NTCVD, New Tools for the Prevention of Cardiovascular Disease in Chronic Kidney Disease.
See this image and copyright information in PMC

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