TY - JOUR
T1 - Chronic kidney disease and cognitive decline in patients with type 2 diabetes at elevated cardiovascular risk
AU - Verhagen, Chloë
AU - Janssen, Jolien
AU - Minderhoud, Crista A
AU - van den Berg, Esther
AU - Wanner, Christoph
AU - Passera, Anna
AU - Johansen, Odd Erik
AU - Biessels, Geert Jan
N1 - Funding Information:
This manuscript is based on data collected from studies sponsored by Boehringer Ingelheim. The manuscript and data analyses have been prepared independently from Boehringer IngelheimThe authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work. OEJ was previously employed by Boehringer Ingelheim. The UMC Utrecht has received research support from Boehringer Ingelheim for GJBs projects. CW has received grant support, fees for advisory services and lecturing from Boehringer Ingelheim.
Publisher Copyright:
© 2022 The Authors
PY - 2022/10
Y1 - 2022/10
N2 - AIMS: We addressed the question whether chronic kidney disease (CKD) may contribute to cognitive decline in type 2 diabetes.METHODS: Participants with type 2 diabetes with elevated cardiovascular risk or CKD from cognition substudies of two large trials were studied prospectively (CARMELINA: n = 2666, mean ± SD age 68.1 ± 8.7 years, CAROLINA: n = 4296; 64.7 ± 9.4 years). Estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) at baseline were related to cognitive performance (Mini-Mental State Examination (MMSE) and attention and executive functioning score (A&E)) in linear regression analyses, adjusted for demographics, cardiovascular risk factors and treatment, at baseline and follow-up.RESULTS: CKD at baseline was more common in CARMELINA than CAROLINA (eGFR<60 in 72.6 % and 19.6 %, macroalbuminuria in 35.0 % and 4.1 %, respectively). Baseline eGFR was related to A&E in CARMELINA (b = 0.02 per 10 ml/min/1.73m
2, 95%CI [0.01,0.03]). Baseline UACR was related to A&E in CAROLINA (b = -0.01 per doubling of UACR mg/g, 95%CI [-0.02,-0.002]). Baseline UACR predicted decline in A&E in CAROLINA (median 6.1 years follow-up; b = -0.01, 95%CI [-0.03,-0.0001] per doubling of UACR mg/g).
CONCLUSIONS: eGFR and UACR were associated with A&E in two cohorts with type 2 diabetes, enriched for CKD and cardiovascular disease. The small effect size estimates indicate limited impact of kidney dysfunction on cognition in this setting.CLINICALTRIALS: GOV IDENTIFIERS: NCT01897532 NCT01243424.
AB - AIMS: We addressed the question whether chronic kidney disease (CKD) may contribute to cognitive decline in type 2 diabetes.METHODS: Participants with type 2 diabetes with elevated cardiovascular risk or CKD from cognition substudies of two large trials were studied prospectively (CARMELINA: n = 2666, mean ± SD age 68.1 ± 8.7 years, CAROLINA: n = 4296; 64.7 ± 9.4 years). Estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) at baseline were related to cognitive performance (Mini-Mental State Examination (MMSE) and attention and executive functioning score (A&E)) in linear regression analyses, adjusted for demographics, cardiovascular risk factors and treatment, at baseline and follow-up.RESULTS: CKD at baseline was more common in CARMELINA than CAROLINA (eGFR<60 in 72.6 % and 19.6 %, macroalbuminuria in 35.0 % and 4.1 %, respectively). Baseline eGFR was related to A&E in CARMELINA (b = 0.02 per 10 ml/min/1.73m
2, 95%CI [0.01,0.03]). Baseline UACR was related to A&E in CAROLINA (b = -0.01 per doubling of UACR mg/g, 95%CI [-0.02,-0.002]). Baseline UACR predicted decline in A&E in CAROLINA (median 6.1 years follow-up; b = -0.01, 95%CI [-0.03,-0.0001] per doubling of UACR mg/g).
CONCLUSIONS: eGFR and UACR were associated with A&E in two cohorts with type 2 diabetes, enriched for CKD and cardiovascular disease. The small effect size estimates indicate limited impact of kidney dysfunction on cognition in this setting.CLINICALTRIALS: GOV IDENTIFIERS: NCT01897532 NCT01243424.
KW - Albuminuria
KW - Attention and executive functioning
KW - Cardiovascular disease
KW - Chronic kidney disease
KW - Cognition
KW - Cognitive decline
KW - Kidney parameters
KW - Type 2 diabetes
UR - https://www.scopus.com/pages/publications/85139185015
U2 - 10.1016/j.jdiacomp.2022.108303
DO - 10.1016/j.jdiacomp.2022.108303
M3 - Article
C2 - 36116359
SN - 1056-8727
VL - 36
JO - Journal of Diabetes and its Complications
JF - Journal of Diabetes and its Complications
IS - 10
M1 - 108303
ER -