AKI Tied to Dementia Risk, Even After Complete Recovery

New research presented at the American Society of Nephrology’s Kidney Week 2018 suggests that acute kidney injury is associated with an increased risk of developing dementia, even after complete kidney recovery.

Jessica B Kendrick, MD, associate professor at the University of Colorado Denver, and colleagues performed a retrospective propensity-matched analysis of 2082 patients from an integrated health care delivery system in Utah. All participants had been admitted to the hospital between January 1, 1999, and December 31, 2009, and had no prior history of dementia. Follow-up lasted 5.8 years.

Mean participant age was 61 years, and mean creatinine at baseline was 0.9 mg/dL. A total of 1041 patients with AKI who experienced complete kidney recovery were propensity score-matched with 1041 patients without AKI upon index admission.

Propensity scores were calculated using demographic information, baseline serum creatinine, prior inpatient visits, season of admission, and all components of the Charlson Comorbidity Index. Time to dementia was compared via proportional hazards analysis in patients with and without AKI.

Over the course of follow-up, 97 patients developed dementia. Dementia risk was found to be 3 times higher in patients with AKI vs those without AKI (hazard ratio 3.4). In this cohort, 7.0% of patients with AKI went on to develop dementia compared with 2.3% of patients without AKI.

“AKI, even with complete kidney recovery, is associated with a significantly increased risk of hospitalized dementia,” the researchers wrote. “Further studies are needed to examine the association of AKI with cognitive dysfunction.”

—Christina Vogt

Reference:

Kendrick JB, Holmen JR, Srinivas T, You Z, Chonchol M, Jovanovich AJ. AKI is associated with an increased risk of dementia. Paper presented at: American Society of Nephrology Kidney Week 2018; October 23-28, 2018; San Diego, CA.