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Observational Study
. 2019 Apr-Jun;41(2):200-207.
doi: 10.1590/2175-8239-jbn-2018-0067. Epub 2018 Sep 13.

Cognition and renal function: findings from a Brazilian population

[Article in English, Portuguese]
Viviane Bernardes de Oliveira Chaiben  1 , Thabata Baechtold da Silveira  1 , Murilo Henrique Guedes  1 , João Pedro de Almeida Fernandes  1 , João Henrique Fregadolli Ferreira  1 , Julianna Beltrão  2 , Giovanna Foltran Leal  2 , Lucas Henrique Olandoski Erbano  1 , Natasha Ludmila Bosch  1 , Roberto Pecoits Filho  1 , Thyago Proença de Moraes  1 , Cristina Pellegrino Baena  1
Affiliations
Observational Study

Cognition and renal function: findings from a Brazilian population

[Article in English, Portuguese]
Viviane Bernardes de Oliveira Chaiben et al. J Bras Nefrol. 2019 Apr-Jun.

Abstract

Introduction: The prevalence of chronic kidney disease (CKD) is increasing, with a potential impact in the risk of acceleration of dementia. The potential association between glomerular filtration rate (eGFR) and cognitive performance was scarcely studied. The aim of this study was to evaluate cognitive performance levels across different degrees of kidney function.

Methods: We analyzed 240 outpatients in a nephrology service, classified according to eGFR: Advanced (≤ 30ml/min/1.73m2), Moderate (30,1ml/min/1.73m2 to ≤ 60ml/min/1.73m2), and Mild CKD (> 60ml/min/1.73m2). Word list memory, Semantic fluency, Mental State Mini Exam and Trail Making Test (TMT) were applied to evaluate cognitive performance. In the TMT, lower scores are associated with better cognition. In linear regression, cognitive function was considered as dependent variables while groups based on eGFR were considered explanatory variables. The group with eGFR > 60ml/min was the reference and models were adjusted for confounding factors.

Results: In our population (n = 240) 64 patients (26.7%) were classified as having advanced, 98(40,8%) moderate, and 78(32,5%) mild. There was no statistical difference among them in MMSE or in the verbal fluency test. However, comparing to mild, patients with advanced CKD presented significantly worse cognitive performance measured by TMTA [50,8s ± 31.1s versus 66,6s ± 35,7s (p = 0.016)] and TMTB [92,7s ± 46,2s versus 162,4s ± 35,7s (p < 0.001)]. Significantly lower TMTB scores (CI95%) 33,0s (4,5-61,6s) were observed in patients with mild compared to advanced CKD in the multivariate analysis adjusting for age, education, sex, diabetes, and alcohol use.

Conclusion: Advanced CKD is independently associated with poorer cognitive performance measured by an executive performance test compared to mild CKD.

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Figure 1. Flow Chart of the participants.
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