Abstract
BackgroundIncreasing studies have focused on the predictive value of high estimated glomerular filtration rate (eGFR) on cardiovascular diseases and mortality; however, the association between high eGFR with cognitive function is still not established. Thus, this study aimed to determine the co-relationship between high eGFR and cognitive performance in the hypertensive population.MethodsWe conducted a baseline cross-sectional study using data from the China H-type Hypertension Registry study. Mini-Mental State Examination (MMSE) assessment was performed to evaluate the cognitive function scale, and serum creatinine was collected to estimate eGFR level. Different MMSE cutoff values were applied in participants with the various educational background to define dementia: <24 in participants with secondary school and above education setting, <20 in those with primary school, and <17 in illiterate participants.ResultsA total of 9,527 hypertensive adults with mean age 63.7 ± 9.8 years and 67% female gender were analyzed. The eGFR cutoff value of 71.52 ml/min/1.73 m2 was found after adjusting for potential covariates in a threshold effect analysis. The MMSE increased significantly with the increment of eGFR (β, 0.27; 95% CI: 0.12–0.41) in participants with eGFR < 71.52 ml/min/1.73 m2 and decreased (β, −0.28; 95% CI: −0.39 to −0.17) in participants with eGFR ≥ 71.52 ml/min/1.73 m2. Individuals with eGFR ≥ 85 ml/min/1.73 m2 have an elevated risk of cognitive impairment than those with eGFR of 65–75 ml/min/1.73 m2. Subgroup analysis showed that a greater reduction degree of MMSE was observed in female individuals and those who had body mass index (BMI) ≥ 24 kg/m2 among participants with eGFR ≥ 71.52 ml/min/1.73 m2.ConclusionOur findings observed an inverted U-shaped relationship between eGFR and cognitive function. Both the low and high levels of eGFR were independently associated with worse cognitive assessment in the hypertensive population.
Highlights
MATERIALS AND METHODSChronic kidney disease (CKD) and dementia are major global health concerns, especially in China, which suffered the most from the dementia burden (Collaborators, 2019; Collaboration, 2020)
This study explored the association between a high level of estimated glomerular filtration rate (eGFR) and cognitive impairment, reconfirming the predictive value of low eGFR to cognitive performance
Our study found that among hypertensive adults, individuals with eGFR ≥ 85 ml/min/1.73 m2 have an elevated risk of cognitive impairment than those with eGFR of 65–75 ml/min/1.73 m2
Summary
MATERIALS AND METHODSChronic kidney disease (CKD) and dementia are major global health concerns, especially in China, which suffered the most from the dementia burden (Collaborators, 2019; Collaboration, 2020). Previous studies have observed that estimated glomerular filtration rate (eGFR) reduction is significantly associated with dementia (Jia et al, 2020). While low eGFR was identified as an independent risk factor for cognitive impairment, the clinical importance of high eGFR was not well-established and has been frequently overlooked. Increasing studies have suggested that high eGFR is independently associated with cardiovascular and all-cause mortality (van der Sande et al, 2017), coronary artery calcification (Choi et al, 2015), and ventricular hypertrophy (Schmieder et al, 1990; Eriksen et al, 2014). Increasing studies have focused on the predictive value of high estimated glomerular filtration rate (eGFR) on cardiovascular diseases and mortality; the association between high eGFR with cognitive function is still not established. This study aimed to determine the co-relationship between high eGFR and cognitive performance in the hypertensive population
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