Kidney disease linked to dementia

[okarol]

Kidney disease linked to dementia

8/1/08 www.nephronline.com

The chances of losing mental faculties with age are increased in older adults with chronic kidney disease, according to two research reports in the August issue of
American Journal of Kidney Diseases.

The good news is that there are medications that decrease albuminuria or protein in the urine, one of the earliest signs of kidney disease, and therefore may prevent or delay cognitive decline.

Abnormalities in the capillaries are found in the brains of people who die of dementia.Similar capillary findings are observed in kidneys of people with albuminuria, leading scientists to predict that albuminuria and vascular disease of the brain may go hand in hand.


As part of the Cardiovascular Health Cognition Study, more than 2000 people over the age of 65 years underwent testing of their memory and thinking skills, and they gave urine samples to measure levels of albumin.

Test results showed that 15% of the subjects had cognitive impairment, a condition in which memory or other cognitive domains are below normal without interfering with daily functioning.  Twelve percent had dementia, defined as a deterioration of intellectual faculties, such as memory, concentration, and judgment, severe enough to interfere with social or occupational functioning.  Mild cognitive impairment is considered to be a transitional phase between normal cognitive function and dementia.

People with albuminuria were about 50% more likely to have dementia
than people without albuminuria, Dr. Joshua I. Barzilay, at Emory
University School of Medicine in Atlanta, Georgia, and his research team report.  The association between the two conditions was still strong after controlling for age, education and risk factors, such as high blood pressure, diabetes, smoking, and cholesterol levels. There was a weaker relationship between albuminuria and mild cognitive impairment.

 
These findings imply that ³albuminuria increases the likelihood that dementia is present or will develop,² Dr. Barzilay and his associates write.

However, if albuminuria is caught and treated early, the brain may possibly be protected from damage due to kidney disease. 

Researchers led by Dr. Manjula Kurella-Tamura, at the University of
California in San Francisco, conducted a similar study to examine the effects of reduced kidney function on cognitive impairment.  More than
23,000 people over the age of 45 were evaluated with a cognitive screening test.  Kidney function was based on estimated glomerular filtration rate, a measure of the kidneys' ability to filter and remove waste products.

The odds of having reduced cognitive ability were increased by 23% among individuals with chronic kidney disease, Kurella-Tamura’s group observed.  More advanced stages of kidney disease were associated with even higher risk of poor mental functioning.

Even those with near-normal kidney function were at increased risk, suggesting that “impairment may occur earlier in the course of kidney disease than previously recognized,” said the authors.

It may be that, by treating kidney dysfunction in its earliest stages, patients will remain cognitively intact and therefore better equipped to follow their doctors’ recommendations for staying healthy.

http://www.nephronline.com/nephnews/index.php?option=com_content&task=view&id=3379&Itemid=1

[stauffenberg]

That's the end of the argument for short daily hemodialysis as equivalent to cadaver transplant, since the creatinine levels will always be higher with dialysis than with transplant.

[Wallyz]

But not extended therapy home hemo. I'm getting down into nearly normal creatinine ranges.

[Zach]

That's the end of the argument for short daily hemodialysis as equivalent to cadaver transplant, since the creatinine levels will always be higher with dialysis than with transplant.

How do you arrive at this conclusion?
This report says nothing specifically about creatinine levels.

One study is about the relationship between albuminuria and dementia:

People with albuminuria were about 50% more likely to have dementia than people without albuminuria, Dr. Joshua I. Barzilay, at Emory
University School of Medicine in Atlanta, Georgia, and his research team report.
 
These findings imply that ³albuminuria increases the likelihood that dementia is present or will develop,² Dr. Barzilay and his associates write.
However, if albuminuria is caught and treated early, the brain may possibly be protected from damage due to kidney disease. 

And a second study that is about the relationship between chronic kidney disease and dementia.  It did not state a specific toxin as to the cause.

The odds of having reduced cognitive ability were increased by 23% among individuals with chronic kidney disease, Kurella-Tamura’s group observed.  More advanced stages of kidney disease were associated with even higher risk of poor mental functioning.

The second study also suggests that " ... even those with near-normal kidney function were at increased risk."  Would you say that might include transplanted kidneys?

 

[stauffenberg]

Albuminuria, which this article discusses, is just a way to measure renal disease, which always involves elevated creatinine in the blood.  If there is danger from even slight deviations from normal renal function which can cause dementia, then excess creatinine is the agent most likely to be causing dementia, since it has already been shown to promote atherosclerosis.

With a transplant it is possible to achieve a constant creatinine value within the normal range of 0.8 to 1.3.  With short daily hemodialysis it is not.  The argument that short daily hemodialysis can be expected to achieve results equivalent to transplant does not deal with the problem that even slight deviations outside that range of normal renal function can cause significant increases in the risk of dementia.

[Zach]

If there is danger from even slight deviations from normal renal function which can cause dementia, then excess creatinine is the agent most likely to be causing dementia, since it has already been shown to promote atherosclerosis.
 

Would you be so kind as to provide a link to the studies that show excess creatinine promotes atherosclerosis?
Thank you.

[kitkatz]

I always knew kidney disease was related to dementia. Just look at my life. 

[flip]

It's also a proven medical fact that dementia increases with age, as does life expectancy. I guess we should all just quit aging.

[Wallyz]

http://www.nature.com/ki/journal/v62/n2/full/4493141a.html

http://findarticles.com/p/articles/mi_m0689/is_n5_v36/ai_13928813

http://cat.inist.fr/?aModele=afficheN&cpsidt=808044

It's pretty well documented.  Google is your friend

Hey, elevated creatinine is  a bad bad thing. we all know that.  This is leaking over form the transplant vs extended daily therapy discussion on other threads, and I think that we should take that discussion back over there.

[Zach]

Hey, elevated creatinine is  a bad bad thing. we all know that.

It may be bad, but I'm not sure if it is more of a marker than has direct causation of dementia.  Again, the article does not state it.

And of course, I've been on hemodialysis for over 26 years and I neither suffer from dementia nor clogged arteries.  Perhaps that is due to my regular exercising and eating well.

[Wallyz]

Regular exercise on Dialysis? that's crazy talk!














There's yer dementia right there, boyo

[Sunny]

O.K., so what is the name of this magic pill I can take to offset albuminuria levels? Somehow I don't think it is quite that easy.