Kidney Function as a Crystal Ball: Predicting Cognitive Decline in Parkinson’s Disease

Published on May 22, 2023

Imagine if the health of your kidneys could reveal insights about your brain. A recent study explored how renal indicators, such as estimated glomerular filtration rate (eGFR), can serve as indicators to monitor cognitive impairment in people with Parkinson’s disease (PD). The researchers recruited over 500 PD patients and measured their kidney function using serum creatinine (Scr), uric acid (UA), and urea nitrogen. They found that eGFR was associated with lower levels of cerebrospinal fluid (CSF) Aβ1-42 and α-synuclein, as well as higher levels of serum neurofilament light chain (NfL) at baseline. Furthermore, a decline in eGFR predicted a higher risk of cognitive impairment over time, along with an increase in CSF tau proteins and NfL. This suggests that monitoring kidney function could help identify PD patients at risk of rapid cognitive decline and track the effectiveness of therapies. So, let’s not overlook the power of our kidneys when it comes to understanding the health of our brains!

BackgroundsThe relationship between kidney function and cognitive impairment in Parkinson’s disease (PD) is poorly understood and underexplored. This study aims to explore whether renal indices can serve as indicators to monitor the cognitive impairment of PD.MethodsA total of 508 PD patients and 168 healthy controls from the Parkinson’s Progression Markers Initiative (PPMI) were recruited, and 486 (95.7%) PD patients underwent longitudinal measurements. The renal indicators including serum creatinine (Scr), uric acid (UA), and urea nitrogen, as well as UA/Scr ratio and estimated glomerular filtration rate (eGFR), were measured. Cross-sectional and longitudinal associations between kidney function and cognitive impairment were evaluated using multivariable-adjusted models.ResultseGFR was associated with lower levels of cerebrospinal fluid (CSF) Aβ1–42 (p = 0.0156) and α-synuclein (p = 0.0151) and higher serum NfL (p = 0.0215) in PD patients at baseline. Longitudinal results showed that decreased eGFR predicted a higher risk of cognitive impairment (HR = 0.7382, 95% CI = 0.6329–0.8610). Additionally, eGFR decline was significantly associated with higher rates of increase in CSF T-tau (p = 0.0096), P-tau (p = 0.0250), and serum NfL (p = 0.0189), as well as global cognition and various cognitive domains (p < 0.0500). The reduced UA/Scr ratio was also linked to higher NfL levels (p = 0.0282) and greater accumulation of T-tau (p = 0.0282) and P-tau (p = 0.0317). However, no significant associations were found between other renal indices and cognition.ConclusioneGFR is altered in PD subjects with cognitive impairment, and predict larger progression of cognitive decline. It may assist identifying patients with PD at risk of rapid cognitive decline and have the potential to monitoring responses to therapy in future clinical practice.

Read Full Article (External Site)

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes:

<a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>