Acute kidney injury may be another dementia risk factor to be aware of.
- Researchers
recently published a study about whether acute kidney injuries raise the
risk of dementia.
- The
researchers looked at the health data from thousands of older adults who
had an acute kidney injury, which is when the kidneys suddenly stop
functioning correctly.
- They
found that acute kidney injuries are associated with a substantially
increased risk for dementia, particularly Lewy body dementia or
Parkinson’s disease-related dementia.
Dementia affects
millions of people in the United States, and some experts believe that case
numbers will continue to rise in the coming years.
With this in mind,
researchers look for early interventions, treatments, and ways to predict
whether someone is at a higher risk for dementia.
Researchers from the
Department of Medical Epidemiology and Biostatistics Karolinska Institutet in
Sweden used data from the Stockholm CREAtinine Measurement (SCREAM) project, which
studies kidney disease.
The scientists checked
to see what percentage of participants had an incidence of acute kidney
injury, and whether or not they developed any form of dementia.
They learned that people who had acute kidney
injuries had a 49% higher chance of dementia than people who did not have an
acute kidney injury.
The study appears in the
journal Neurology.
Why it’s
important to identify dementia risk factors
Dementia affects
cognitive abilities and can cause memory loss, loss of language skills, and
emotional issues. According to the National Institute on Aging, dementia occurs because of
“changes in certain brain regions that cause neurons (nerve cells) and their
connections to stop working properly.”
The Population Reference
Bureau reports that around 7 million older adults in the U.S.
have some form of dementia, and the group anticipates that number to nearly
double by 2040.
Alzheimer’s disease makes
up the majority of dementia cases, and some other types of dementia include Lewy body
dementia, vascular
dementia, and mixed dementia.
There is currently no
cure for dementia, but some medications can slow down progression or help
manage symptoms.
The authors of the
current study noted that certain risk factors, such as hypertension,
obesity, and alcohol use may contribute to dementia, and they wanted to focus
on whether acute kidney injury increases the risk.
“Ascertaining additional risk factors of dementia is
important for identifying high-risk individuals early and advancing preventative
and monitoring strategies,” the authors write.
The authors noted that
acute kidney injury carries a higher risk of mortality, and may disrupt
the blood-brain
barrier.
Creatinine
measurements as kidney injury indicators
The researchers used
data from the SCREAM project, which tracks healthcare data from Swedish
citizens.
The researchers analyzed
data from around 300,000 adults who were at least 65 years old at the time of
their first outpatient creatinine measurement. Creatinine measurement assesses
kidney function.
Part of the researchers’
inclusion criteria was that participants could not have a dementia diagnosis at
the beginning of the study.
The participants had a
mean age of 75 years, and 56.6% of the participants were female. The
participants had a median follow-up of 12.3 years.
The researchers used
follow-up creatinine measurements to assess for acute kidney injury events. The
authors considered acute kidney injury events to have occurred when
participants had a creatinine measurement of 1.5 times higher than their
baseline, a creatinine measurement of 0.3 milligrams per deciliter (mg/dL)
higher than average, or an incidence of temporary dialysis.
The researchers took
note of any dementia findings. They based this on whether participants started
antidementia drugs, diagnostic codes, or registration in the Swedish registry of cognitive/dementia disorders (Sve/Dem).
Acute kidney
injuries lead to an increase in the risk of dementia
After going through the
SCREAM project records, the scientists were able to link an incident of acute
kidney injury to developing dementia.
Around 26% of the participants had at least one
incident of an acute kidney injury, and 16% developed dementia.
The study found that the
rate of dementia was significantly higher after an acute kidney injury
incident, and individuals had a 49% increased risk of developing dementia
compared to before experiencing an acute kidney injury.
When taking the severity
of the acute kidney injury into consideration, the authors noted that people
who had more severe acute kidney injury cases, or acute kidney injuries that
required hospitalization had a higher dementia risk.
The researchers also
looked at specific dementia types to see whether the acute kidney injury risk
was higher for some types over others. The authors noted an increased risk in
the following:
- 88% for Lewy body dementia or Parkinson’s disease-related dementia
- 47% for vascular
dementia
- 31% for Alzheimer’s disease.
Overall, the study
highlights that people who have acute kidney injuries – especially those who
have severe acute kidney injury incidents – may need extra attention in terms
of monitoring their cognitive health.
“As a clinical application, this study thus
identifies individuals with [acute kidney injury] as a population in which
monitoring for dementia and potential preventive and therapeutic strategies may
be indicated,” note the authors.
Study
findings may change clinical practice
Jason Krellman, PhD, an associate professor of Neuropsychology
in Neurology at Columbia University Irving Medical Center in New York and
president of the New York Neuropsychology Group, who was not involved in this
study, spoke with Medical News Today about the research.
“[Acute kidney injury]
is associated with hypertension and heart disease, so damage to blood vessels
in the brain might help explain the increased risk of dementia, especially
vascular dementia,” explained Krellman. “Relatedly, there might be a link
between blood vessel disease and inflammation in the brain with other types of
conditions that cause dementia too, but the mechanisms are still unclear.”
Krellman also explained
that the study results could make providers aware of the possible need to see a
neurologist after a severe acute kidney injury for assessment or to “get a
baseline in case there is change in the future so that symptoms are caught
early.”
In addition to acute
kidney injuries, chronic
kidney disease can also impact the risk of dementia.
“We have known for some
time that kidney disease or failure contributes to cognitive decline and
possible dementia, especially in sicker individuals and those well over 65,”
said Krellman.
For people concerned
about their dementia risk, Krellman had a few suggestions:
“Patients
with [acute kidney injury] should do everything possible to lower their
vascular risk factors, such as hypertension, high cholesterol, and diabetes,”
noted Prof. Krellman. “This means adopting a heart-healthy lifestyle, including
aerobic exercise as tolerated, proper diet, and cutting out smoking.”
Sham Singh,
MD, a psychiatrist at Winit Clinic in Santa Monica, CA, who was not
involved in the study, also spoke with MNT about its
findings.
“The recent findings
linking acute kidney injury with an increased risk of dementia could lead to
significant changes in clinical practice,” Singh told us.
Singh further explained
that the findings would help enhanced monitoring, integrative care approaches,
and preventative strategies.
“Given the connection between [acute kidney injury]
and cognitive decline, I think there will likely be a need for more rigorous
monitoring of cognitive function in these patients,” he commented. “Regular
cognitive assessments could become a standard part of follow-up care, enabling
early detection of potential dementia.”
Singh also said the
findings emphasize the need for an multidisciplinary care approach.
“Collaboration among
nephrologists, neurologists, and geriatricians will be essential to provide
comprehensive care,” explained Singh. “This multidisciplinary approach ensures
that both kidney and brain health are addressed simultaneously, optimizing
patient outcomes through coordinated care.”
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