Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology and Psichiatry, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, Roma 00128, Italy; Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, Roma 00128, Italy.
Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology and Psichiatry, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, Roma 00128, Italy; Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, Roma 00128, Italy.
Behav Brain Res. 2025 Feb 4;477:115289. doi: 10.1016/j.bbr.2024.115289. Epub 2024 Oct 11.
Alzheimer's disease (AD) is pathologically characterized by the deposition of beta-amyloid and tau-protein. Blood biomarkers (BBM) might be employed for detecting these abnormal proteins in vivo. As the kidney is an important excretory organ, a decreased renal function might affect the clearance of BBM. In this study we aimed to assess the relationship between kidney function, the levels of BBM and cognitive impairment in a cohort of patients with a biological AD diagnosis without chronic kidney disease (CKD).
This is a retrospective cohort study on AD patients. Data regarding medical history at diagnosis (T0) were retrieved, together with the Mini-Mental State Examination (MMSE) score at T0 and after 6 months (T1). Cerebrospinal fluid and blood samples were collected and concentrations of Aβ42, Aβ40, t-Tau, and p-Tau181 were determined using commercially available kits. Kidney function was estimated through the 2021-CKD-EPI equation. To assess the effects of creatinine on our parameters of interest, we grouped patients into two groups -creatinine level <0.8 mg/dl (LOW) or ≥0.8 mg/dl (HIGH).
The median MMSE score decreased significantly between the two timepoints. When we assessed for differences in the parameters of interest between subgroups, we found that only Aβ42 plasma level was significantly different in the HIGH vs LOW group.
We found out that only Aβ42 plasma levels are influenced by kidney function, while the other AD biomarkers are not affected by creatinine levels or eGFR. Our findings are consistent with the hypothesis of renal clearance of Aβ isoforms.
阿尔茨海默病（AD）在病理学上的特征是β-淀粉样蛋白和tau 蛋白的沉积。血液生物标志物（BBM）可用于体内检测这些异常蛋白。由于肾脏是重要的排泄器官，肾功能下降可能会影响 BBM 的清除。在这项研究中，我们旨在评估肾功能、BBM 水平与无慢性肾脏病（CKD）的生物 AD 诊断患者认知障碍之间的关系。
这是一项关于 AD 患者的回顾性队列研究。我们检索了诊断时（T0）的病史数据，以及 T0 和 6 个月后（T1）的简易精神状态检查（MMSE）评分。收集脑脊液和血液样本，并使用市售试剂盒测定 Aβ42、Aβ40、t-Tau 和 p-Tau181 的浓度。通过 2021-CKD-EPI 方程估算肾功能。为了评估肌酐对我们感兴趣参数的影响，我们将患者分为两组 -肌酐水平<0.8mg/dl（LOW）或≥0.8mg/dl（HIGH）。
MMSE 评分在两个时间点之间显著下降。当我们评估亚组间感兴趣参数的差异时，我们发现只有 Aβ42 血浆水平在 HIGH 与 LOW 组之间存在显著差异。
我们发现只有 Aβ42 血浆水平受肾功能影响，而其他 AD 生物标志物不受肌酐水平或 eGFR 影响。我们的发现与 Aβ 同工型的肾清除假说一致。
