The Brain in Kidney Disease (BRINK) Cohort Study: Design and Baseline Cognitive Function.

Am J Kidney Dis 2016 Apr 29;67(4):593-600. Epub 2015 Dec 29.

Department of Neurology, Mayo Clinic, Rochester, MN.

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 m(2).

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 m(2) (non-dialysis dependent), and control, defined as eGFR≥60 mL/min/1.73 m(2).

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 m(2), respectively. Mean eGFR in reduced-eGFR participants was 34.3 mL/min/1.73 m(2). Baseline cognitive performance was significantly associated with eGFR in all domains except language. Participants with eGFRs<30 mL/min/1.73 m(2) performed significantly worse than those with eGFRs≥30 mL/min/1.73 m(2) 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 m(2). Future BRINK analyses will measure risk factors for cognitive decline using the longitudinal data.

Download full-text PDF

Source
http://dx.doi.org/10.1053/j.ajkd.2015.11.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5271565PMC
April 2016
45 Reads

Publication Analysis

Top Keywords

kidney disease
12
cohort study
8
disease brink
8
cognitive impairment
8
brain kidney
8
cognitive function
8
cognitive
5
epidemiology cognitive
4
study epidemiology
4
observational cohort
4
ckd primary
4
characterize association
4
aim characterize
4
primary aim
4
longitudinal observational
4
impairment ckd
4
resultsstudy design
4
methods study
4
design methods
4
rationale design
4

Similar Publications