Association between kidney measurements and cognitive performance in patients with ischemic stroke

• Published in: PloS one 2023-12, Vol.18 (12), p.e0292506-e0292506
• Main Authors: Zhang, Chunyan, Xue, Guofang, Hou, Yanjuan, Meng, Pengfei, Gao, Huizhong, Bai, Bo, Li, Dongfang
• Format: Article
• Language: English
• Subjects: Age; Albumin; Analysis; Biology and Life Sciences; Blood pressure; Body mass index; Cerebrovascular disease; Cholesterol; Chronic kidney failure; Cognition disorders; Cognitive ability; Cognitive tasks; Complications and side effects; Creatinine; Dementia; Dextrose; Diabetes; Diabetes mellitus; Diagnosis; Epidermal growth factor receptors; Females; Glomerular filtration rate; Glucose; Homocysteine; Hospitals; Hypertension; Impairment; Ischemia; Kidney diseases; Kidneys; Longitudinal studies; Medical records; Medical research; Medicine and Health Sciences; Medicine, Experimental; Older people; Patients; Regression analysis; Renal function; Risk factors; Stroke; Stroke (Disease); Stroke patients; Triglycerides; Type 2 diabetes; Uric acid; Variables; Variance analysis
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0292506

Individuals with chronic kidney disease (CKD) are at a substantially higher risk for stroke, which may predispose individuals to cognitive impairment. However, the association of low estimated glomerular filtration rate (eGFR) and albuminuria with poorer cognitive performance in patients with stroke is not fully understood, and the current evidence for this association is contradictory. Our aim was to retrospectively investigate whether low eGFR and albuminuria, as indicated by the urine albumin-creatinine ratio (UACR), are independently or jointly associated with worse cognitive performance in patients with ischemic stroke. This retrospective study included 608 patients with acute ischemic stroke. Their UACR and eGFR values were obtained from inpatient medical records. Global cognitive function was assessed with the mini-mental state exam (MMSE) and Montreal Cognitive Assessment (MoCA) one month after hospital discharge. The relationship between renal measures and cognitive performance was assessed using univariate and multiple linear regression analyses. Potential confounders included age, gender, BMI, education, diabetes and hypertension history, NIHSS score, smoking and alcohol consumption status, serum total cholesterol, triglyceride, fasting glucose, uric acid, homocysteine, systolic blood pressure, and either eGFR or UACR. Patients had an average age of 66.6±4.1 years, and 48% were females. Average eGFR and UACR were 88.4±12.9 ml/min/1.73m2 and 83.6±314.2 mg/g, respectively. The number of patients with eGFR ≥90, 60-89, and