Zoccali Carmine, Mallamaci Francesca, Rosenberg Kerry, Unwin Robert, Silva Pedro Imenez, Simeoni Maria Adelina, Hafez Gaye, Capasso Giovambattista, Nitsch Dorothea
Renal Research Institute, New York, NY, USA.
Institute of Molecular Biology and Genetics (Biogem), Ariano Irpino (AV), Italy.
Nephrol Dial Transplant. 2025 Mar 13;40(Supplement_2):ii37-ii45. doi: 10.1093/ndt/gfae255.
Research on cognitive function in individuals with chronic kidney disease (CKD) is critical due to the significant public health challenge posed by both CKD and cognitive impairment. CKD affects approximately 10-15% of the adult population, with higher prevalence in the elderly, who are already at increased risk for cognitive decline. Cognitive impairment is notably higher in CKD patients, particularly those with severe stages of the disease, and progresses more rapidly in those on dialysis. This review explores how data from large biobank studies such as the Alzheimer's Disease Neuroimaging Initiative, UK Biobank, and others could be used to enhance understanding the progression and interplay between CKD and cognitive decline. Each of these data sources has specific strengths and limitations. Strengths include large sample sizes and longitudinal data across different groups, and in different settings. Addressing limitations leads to challenges in dealing with heterogeneous data collection methods, and addressing missing data, which requires the use of sophisticated statistical techniques. Combining data from multiple databases can mitigate individual study limitations, particularly via the 'epidemiological triangulation' concept. Using such data appropriately holds immense potential to better understand the pathobiology underlying CKD and cognitive impairment. Addressing the inherent challenges with a clear strategy is crucial for advancing our understanding and improving the lives of those affected by both CKD and cognitive impairment.
鉴于慢性肾脏病（CKD）和认知障碍对公共卫生构成的重大挑战，对CKD患者的认知功能进行研究至关重要。CKD影响约10%-15%的成年人口，在老年人中患病率更高，而老年人本身认知能力下降的风险就更高。CKD患者的认知障碍明显更高，尤其是疾病严重阶段的患者，并且在透析患者中进展更快。本综述探讨了如何利用来自大型生物样本库研究（如阿尔茨海默病神经影像学倡议、英国生物样本库等）的数据，来增进对CKD与认知能力下降之间进展和相互作用的理解。这些数据源中的每一个都有其特定的优势和局限性。优势包括样本量大以及不同群体、不同环境下的纵向数据。解决局限性会带来处理异质性数据收集方法以及处理缺失数据方面的挑战，这需要使用复杂的统计技术。整合来自多个数据库的数据可以减轻单个研究的局限性，特别是通过“流行病学三角验证”概念。恰当地使用这些数据对于更好地理解CKD和认知障碍背后的病理生物学具有巨大潜力。以明确的策略应对内在挑战对于推进我们的理解以及改善受CKD和认知障碍影响者的生活至关重要。
