Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China.
Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China.
Mayo Clin Proc. 2024 Sep;99(9):1399-1410. doi: 10.1016/j.mayocp.2024.04.017. Epub 2024 Aug 6.
To investigate the causal dose-response association between cognitive function and the risk of chronic kidney disease (CKD) by a longitudinal cohort and mendelian randomization study.
The longitudinal cohort study included 396,600 participants without prior dementia and CKD from the UK Biobank. Cognitive function (including prospective memory, numeric memory, visuospatial memory, reaction time, and reasoning ability) was assessed by computerized touchscreen tests. Global cognitive function was defined as a composite score of those specific cognitive domains. A 2-stage mendelian randomization analysis was conducted with 12,979 cases of CKD and 379,424 controls. Genetically predicted global cognitive function was instrumented with 91 confirmed genome-wide significant variants. The study outcome was new-onset CKD. The study was conducted from March 13, 2006, to September 30, 2021.
During a median follow-up of 12.5 years, new-onset CKD developed in 13,090 participants. Per 1 SD score increments in reaction time (adjusted hazard ratio [HR], 0.97; 95% CI, 0.95 to 0.99), reasoning ability (adjusted HR, 0.91; 95% CI, 0.88 to 0.94), and global cognitive function (adjusted HR, 0.96; 95% CI, 0.95 to 0.98) were associated with a significantly lower risk of new-onset CKD. Compared with an incorrect answer in the prospective memory test, a correct answer was associated with a lower risk of new-onset CKD (adjusted HR, 0.82; 95% CI, 0.76 to 0.88). Mendelian randomization analyses found that per 1 SD score increments in genetically predicted global cognitive function resulted in a significantly (7%; 95% CI, 2% to 12%) lower risk of new-onset CKD.
A better cognitive function is causally associated with a lower risk of CKD in participants without prior dementia.
通过纵向队列和孟德尔随机化研究，调查认知功能与慢性肾脏病（CKD）风险之间的因果剂量-反应关联。
纵向队列研究纳入了来自英国生物库的 396600 名无痴呆和 CKD 病史的参与者。认知功能（包括前瞻性记忆、数字记忆、视觉空间记忆、反应时间和推理能力）通过计算机触摸屏测试进行评估。整体认知功能定义为这些特定认知领域的综合评分。对 12979 例 CKD 病例和 379424 例对照进行了 2 阶段孟德尔随机化分析。全基因组关联分析确定的 91 个确认的显著变异作为整体认知功能的遗传预测工具。研究结果为新发 CKD。研究于 2006 年 3 月 13 日至 2021 年 9 月 30 日进行。
在中位随访 12.5 年期间，13090 名参与者发生新发 CKD。反应时间每增加 1 个标准差得分（调整后的危险比 [HR]，0.97；95%置信区间 [CI]，0.95 至 0.99）、推理能力（调整后的 HR，0.91；95%CI，0.88 至 0.94）和整体认知功能（调整后的 HR，0.96；95%CI，0.95 至 0.98）与新发 CKD 的风险显著降低相关。与前瞻性记忆测试中回答错误相比，回答正确与新发 CKD 的风险降低相关（调整后的 HR，0.82；95%CI，0.76 至 0.88）。孟德尔随机化分析发现，遗传预测的整体认知功能每增加 1 个标准差得分，新发 CKD 的风险显著降低（7%；95%CI，2%至 12%）。
在无痴呆病史的参与者中，认知功能较好与 CKD 风险较低具有因果关系。
