|The following article features coverage from the National Kidney Foundation’s 2019 Spring Clinical Meetings. Click here to read more of Renal & Urology News’ conference coverage.|
Dementia is an early predictor of chronic kidney disease (CKD) progression, vascular events, and all cause-mortality in type 2 diabetes patients, according to researchers who presented study findings at the National Kidney Foundation’s 2019 Spring Clinical Meetings in Boston.
In a large cohort of veterans with type 2 diabetes, 9205 had dementia and 93,062 did not, Aditi Gupta, MD, of the University of Kansas Medical Center in Kansas City, and colleagues reported. At baseline, both groups were comparable after propensity score matching by sex, prior acute kidney injury, use of angiotensin converting enzyme inhibitors and angiotensin-receptor blockers, and follow-up time.
Dementia diagnoses preceded vascular events by a mean 2998 days, or roughly 8 years. With respect to CKD progression, significantly more patients with than without dementia exceeded serum creatinine values of more than 1.5 mg/dL (38.9% vs 12.6%), more than 3 mg/dL (8.6% vs 7.2%), and more than 6 mg/dL (3.2% vs 2.7%). Patients with dementia also had faster CKD progression. Proteinuria was similar in both groups.
In addition, diabetes patients with dementia were significantly more likely to experience new vascular events, including coronary artery disease (9.2% vs 7.9%), myocardial infarction (2.8% vs 1.7%), and cerebrovascular accidents (10.6% vs 4.8%). Most importantly, nearly twice as many patients with dementia died from any cause (with no change in time to death): 24.7% vs 12.6%. Glucose control did not explain any of the associations.
It’s important to assess cognition in type 2 diabetes patients with kidney disease, Dr Gupta told Renal & Urology News. “Vascular changes in the brain are common with diabetes, and patients with diabetes have a higher incidence of vascular dementia. A diagnosis of dementia in patients with diabetes may predict future systemic vascular disease, kidney disease progression, and mortality.”
Read more of Renal & Urology News’ coverage of NKF’s 2019 Spring Clinical Meetings by visiting the conference page.
Gupta A, Wiegmann P, Garcia-Touza M, et al. Dementia is a novel and significant early signal of progression of kidney disease and increased mortality. Poster presented at the National Kidney Foundation’s 2019 Spring Clinical Meetings in Boston, May 8-12, 2019. Poster 197.