Association of renal function with cognitive progression in de novo Parkinson’s disease

Abstract

Background

People with chronic kidney disease (CKD) who had decreased renal function were more likely to develop cognitive decline in contrast to the general population.

Objective

Whether renal function parameters can effectively predict cognitive progress in Parkinson’s disease is not yet clear.

Methods

In the present study, 612 de novo Parkinson’s Disease (PD) patients from the Parkinson’s Progression Markers Initiative (PPMI) database were recruited. To examine the associations between renal function parameters and cognition we utilized multiple linear regression models and mixed-effects models. Cox regression was used to investigate whether the renal function parameters were the risk factors for developing dementia in PD participants.

Results

Regression analyses indicated that creatinine (Cr), blood urea nitrogen (BUN), Blood urea nitrogen / Creatinine ratio (BUN/Cr), and estimated glomerular filtration rate(eGFR) were strongly associated with cognitive score as indicated by global cognition (MoCA, β = 0.066, p = 0.015; β = -0.043, p = 0.025; β = -0.070, p < 0.001; β = -0.058, p = 0.013, respectively). Serum uric acid (SUA) and the serum uric acid / Creatinine ratio (SUA/Cr) were associated with cognitive decline as indicated by executive function/working memory (LNS, β = -0.045, p < 0.001; β = -0.032, p = 0.025, respectively). Higher SUA/Cr and eGFR were associated with a higher incidence of developing PD dementia after an average follow-up of 7.26 ± 2.50 years (HR = 1.014, 95 % CI 1.004 to 1.024, p = 0.006; HR = 1.190, 95 % CI 1.023 to 1.384, p = 0.025, respectively).

Conclusions

Our findings revealed the relationship between renal function and cognition in PD patients, which indicated that renal function might play a role in cognitive progression in de novo Parkinson’s.