A large-scale study of 5,607 adults reveals that more severe chronic kidney disease (CKD) is strongly associated with higher risk of cognitive impairment. The research, part of the Chronic Renal Insufficiency Cohort (CRIC) Study, followed participants for up to 16 years.
Cognitive performance was evaluated using standardized tests assessing memory, attention, processing speed, and executive function. Participants with baseline cognitive issues were excluded to focus on new-onset cases.
Results showed that proteinuria-measured by urinary protein-to-creatinine ratio (UPCR)-was a powerful predictor. Each standard deviation increase in log-transformed UPCR correlated with a 21% greater risk of attention and processing speed decline, and a 16% rise in executive function impairment.
Lower estimated glomerular filtration rate (eGFR) initially linked to poor performance but lost significance after adjusting for UPCR, suggesting proteinuria may be the stronger indicator.
Those with both reduced eGFR (<60 mL/min/1.73 m²) and elevated UPCR (≥150 mg/g) faced a 38% higher risk of global cognitive decline compared to those with milder CKD.
The findings urge clinicians to integrate cognitive monitoring into CKD management and prioritize proteinuria in risk assessment.