TY - JOUR
T1 - The brain in kidney disease (BRINK) cohort study
T2 - Design and baseline cognitive function
AU - Murray, Anne M.
AU - Bell, Elizabeth J.
AU - Tupper, David E.
AU - Davey, Cynthia S.
AU - Pederson, Sarah L.
AU - Amiot, Elizabeth M.
AU - Miley, Kathleen M.
AU - McPherson, Lauren
AU - Heubner, Brooke M.
AU - Gilbertson, David T.
AU - Foley, Robert N.
AU - Drawz, Paul E.
AU - Slinin, Yelena
AU - Rossom, Rebecca C.
AU - Lakshminarayan, Kamakshi
AU - Vemuri, Prashanthi
AU - Jack, Clifford R.
AU - Knopman, David S.
N1 - Publisher Copyright:
© 2016 National Kidney Foundation, Inc.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Background The Brain in Kidney Disease (BRINK) Study aims to identify mechanisms that contribute to increased risk for cognitive impairment in patients with chronic kidney disease (CKD). We describe the rationale, design, and methods of the study and report baseline recruitment and cognitive function results. Study Design Longitudinal observational cohort study of the epidemiology of cognitive impairment in CKD. The primary aim is to characterize the association between (1) baseline and incident stroke, white matter disease, estimated glomerular filtration rate (eGFR), inflammation, microalbuminuria, and dialysis initiation and (2) cognitive decline over 3 years in a CKD cohort with a mean eGFR < 45 mL/min/1.73 m2. Setting & Participants Community-dwelling participants 45 years or older recruited from 4 health systems into 2 groups: reduced eGFR, defined as eGFR < 60 mL/min/1.73 m2 (non-dialysis dependent), and control, defined as eGFR ≥ 60 mL/min/1.73 m2. Predictor eGFR group. Outcomes Performance on cognitive function tests and structural brain magnetic resonance imaging. Measurements Sequential cognitive and physical function testing, serum and urine biomarker measurement, and brain magnetic resonance images over 3 years. Results Of 554 participants, mean age was 69.3 years; 333, 88, and 133 had eGFRs < 45 (non-dialysis dependent, nontransplantation), 45 to <60, and ≥60 (controls) mL/min/1.73 m2, respectively. Mean eGFR in reduced-eGFR participants was 34.3 mL/min/1.73 m2. Baseline cognitive performance was significantly associated with eGFR in all domains except language. Participants with eGFRs < 30 mL/min/1.73 m2 performed significantly worse than those with eGFRs ≥ 30 mL/min/1.73 m2 on tests of memory, processing speed, and executive function. Participants with reduced eGFRs overall scored worst on the Immediate Brief Visual-Spatial Memory Test-Revised. Limitations Healthy cohort bias, competing risk for death versus cognitive decline. Conclusions Cognitive function was significantly worse in participants with eGFRs < 30 mL/min/1.73 m2. Future BRINK analyses will measure risk factors for cognitive decline using the longitudinal data.
AB - Background The Brain in Kidney Disease (BRINK) Study aims to identify mechanisms that contribute to increased risk for cognitive impairment in patients with chronic kidney disease (CKD). We describe the rationale, design, and methods of the study and report baseline recruitment and cognitive function results. Study Design Longitudinal observational cohort study of the epidemiology of cognitive impairment in CKD. The primary aim is to characterize the association between (1) baseline and incident stroke, white matter disease, estimated glomerular filtration rate (eGFR), inflammation, microalbuminuria, and dialysis initiation and (2) cognitive decline over 3 years in a CKD cohort with a mean eGFR < 45 mL/min/1.73 m2. Setting & Participants Community-dwelling participants 45 years or older recruited from 4 health systems into 2 groups: reduced eGFR, defined as eGFR < 60 mL/min/1.73 m2 (non-dialysis dependent), and control, defined as eGFR ≥ 60 mL/min/1.73 m2. Predictor eGFR group. Outcomes Performance on cognitive function tests and structural brain magnetic resonance imaging. Measurements Sequential cognitive and physical function testing, serum and urine biomarker measurement, and brain magnetic resonance images over 3 years. Results Of 554 participants, mean age was 69.3 years; 333, 88, and 133 had eGFRs < 45 (non-dialysis dependent, nontransplantation), 45 to <60, and ≥60 (controls) mL/min/1.73 m2, respectively. Mean eGFR in reduced-eGFR participants was 34.3 mL/min/1.73 m2. Baseline cognitive performance was significantly associated with eGFR in all domains except language. Participants with eGFRs < 30 mL/min/1.73 m2 performed significantly worse than those with eGFRs ≥ 30 mL/min/1.73 m2 on tests of memory, processing speed, and executive function. Participants with reduced eGFRs overall scored worst on the Immediate Brief Visual-Spatial Memory Test-Revised. Limitations Healthy cohort bias, competing risk for death versus cognitive decline. Conclusions Cognitive function was significantly worse in participants with eGFRs < 30 mL/min/1.73 m2. Future BRINK analyses will measure risk factors for cognitive decline using the longitudinal data.
KW - Cognitive impairment
KW - attention
KW - brain aging
KW - chronic kidney disease (CKD)
KW - estimated glomerular filtration rate (eGFR)
KW - executive function
KW - language
KW - memory
KW - neuropsychological testing
KW - processing speed
KW - renal function
KW - stroke
KW - structural brain magnetic resonance imaging
KW - study design
UR - http://www.scopus.com/inward/record.url?scp=84951914396&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84951914396&partnerID=8YFLogxK
U2 - 10.1053/j.ajkd.2015.11.008
DO - 10.1053/j.ajkd.2015.11.008
M3 - Article
C2 - 26744128
AN - SCOPUS:84951914396
SN - 0272-6386
VL - 67
SP - 593
EP - 600
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 4
ER -