Cognitive Impairment Risk Increased With Severity of Chronic Kidney Disease

Higher urinary protein-to-creatinine ratio linked to increased risk for impairment in attention and processing speed, executive function
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FRIDAY, Feb. 20, 2026 (HealthDay News) -- For patients with chronic kidney disease (CKD), severity of CKD is associated with an increased incidence of cognitive impairment, according to a study published online Feb. 17 in JAMA Network Open.

Zhijie Huang, Ph.D., from the Tulane University School of Public Health and Tropical Medicine in New Orleans, and colleagues examined associations between CKD severity based on the estimated glomerular filtration rate (eGFR) and urinary protein-to-creatinine ratio (UPCR) and incident cognitive impairment in a study involving 5,607 participants with CKD.

The researchers found that each 1 standard deviation (SD) higher log-transformed UPCR was associated with an increased risk for impairments in attention and processing speed and impairment in executive function (hazard ratios, 1.21 and 1.16, respectively) in multivariable-adjusted analyses. Each 1 SD lower eGFR was associated with an increased risk for impairment in attention and processing speed (hazard ratio, 1.21). After further adjustment for eGFR, findings for UPCR remained nominally significant, while eGFR findings were attenuated with adjustment for UPCR. Compared with those with an eGFR of 60 mL/min/1.73 m2 or more and UPCR less than 150 mg/g, patients with a combined eGFR less than 60 mL/min/1.73 m2 and UPCR of 150 mg/g or more had a significantly increased risk for impairment in global cognition (hazard ratio, 1.38).

"More advanced proteinuria was significantly associated with impairments in attention and processing speed as well as executive function," the authors write. "Although a decreased eGFR was also associated with attention and processing speed, proteinuria largely explained this association."

Two authors disclosed ties to the biopharmaceutical industry.

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