A NEW study revealed a concerning connection between acute kidney injury (AKI) and cognitive decline, including mild cognitive impairment (MCI) and probable dementia, among older adults at high cardiovascular risk. Conducted as a retrospective cohort analysis using data from the Systolic Blood Pressure Intervention Trial (SPRINT), the research highlights the long-term cognitive consequences of even mild and reversible AKI.
The study included 8,148 participants with an average age of 68 years, 65% of whom were male, and nearly one-third had pre-existing chronic kidney disease (CKD). Over a median follow-up of four years, the incidence rates of MCI, dementia, and their composite were significantly higher in participants who experienced an AKI event. After adjusting for confounding factors, AKI was associated with a 72% increased risk of probable dementia and a 43% increased risk of the composite outcome of MCI and dementia.
Lead author Dr. Kristen L. Nowak emphasised the significance of these findings, stating, “Our results suggest that even mild AKI, often regarded as reversible, can have lasting impacts on cognitive health.” The research underscores the importance of monitoring cognitive function in patients who have experienced AKI, particularly in populations with existing cardiovascular risks.
While the study did not include AKI events prior to its baseline and acknowledges its retrospective nature, the findings provide compelling evidence linking kidney health to brain health. The researchers advocate for further investigation into the mechanisms driving this association and the development of interventions to mitigate the cognitive risks posed by AKI.
This study serves as a wake-up call for clinicians to consider the potential cognitive sequelae of AKI and highlights the need for comprehensive care strategies in managing older patients with cardiovascular and kidney-related health issues.
Aleksandra Zurowska, EMJ
Reference
Nowak KL et al. Acute Kidney Injury, Mild Cognitive Impairment, and Dementia: A Cohort Study of Patients from SPRINT. Kiney Med. 2024;DOI: 10.1016/j.xkme.2024.100962.
