Brain function and kidney health: Good cognitive function may reduce risk of chronic kidney disease

Today we are going to talk about cognitive function, a multidimensional "super system"! Cognition is the process by which the human brain receives external information, processes it, and converts it into internal psychological activities, thereby acquiring knowledge or applying knowledge. Cognitive decline refers to the obvious, measurable decline or abnormality in multiple aspects of an individual's cognitive functions such as memory, language, reasoning, execution, calculation, and understanding and judgment. The decline in cognitive function is a gradual process, undergoing a gradual transition from normal to dementia. The decline in cognitive function may lead to the occurrence and development of chronic diseases through various pathways. Studies have found that cognitive function is associated with hypertension, diabetes, and cardiovascular disease. However, no studies have yet explored whether the level of cognitive function, especially different aspects of cognitive function, will affect the future risk of chronic kidney disease.

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In response to the above issues, the National Clinical Research Center for Kidney Diseases of Nanfang Hospital of Southern Medical University carried out relevant work, and the research results were published in the journal Mayo Clinic proceedings . The study found that there is a causal relationship between better cognitive function (including reaction time, reasoning ability, prospective memory and overall cognitive function) and a lower risk of chronic kidney disease. Professor Qin Xianhui of the National Clinical Research Center for Kidney Diseases of Nanfang Hospital is the corresponding author of the article, and doctoral student Yang Sisi is the first author.

The study included 396,600 participants who were free of dementia and chronic kidney disease at baseline. Cognitive function was assessed by:

(1) Prospective memory: assesses whether participants can correctly remember previous instructions after being distracted;

(2) Numeric memory: measures the participant’s ability to remember the longest string of numbers;

(3) Visuospatial memory: examines the participant’s ability to recall the location of cards;

(4) Reaction time: measures the speed at which participants process information;

(5) Reasoning ability: Assess the participants’ fluid intelligence by answering logic/reasoning questions.

On these five tests, higher scores represent better cognitive functioning of the participants.

After 12.5 years of follow-up, a total of 13,090 (3.3%) participants developed chronic kidney disease. The study showed that:

(1) For every 1 standard deviation increase in reaction time, reasoning ability, and overall cognitive function scores, the risk of new-onset chronic kidney disease was significantly reduced by 3%, 9%, and 4%, respectively (Figure 1);

(2) In the prospective memory test, participants who answered correctly had a significantly lower risk of developing chronic kidney disease by 18% compared with participants who answered incorrectly ;

(3) In a two-stage Mendelian randomization analysis, the risk of chronic kidney disease decreased by 7% for every 1 standard deviation increase in the genetically predicted overall cognitive function score, suggesting a causal relationship between cognitive function and the risk of chronic kidney disease .

Figure 1 Cognitive function scores in different dimensions are negatively correlated with the risk of new-onset chronic kidney disease

Conclusions: This large, prospective study showed a causal association between better cognitive function and a lower risk of developing chronic kidney disease . If this finding is confirmed, simple, noninvasive tests of cognitive function may become an early and cost-effective tool for identifying people at high risk of developing chronic kidney disease.

In daily life, in addition to improving cognitive function through specific programs such as brain games and memory training, we can also maintain or improve cognitive function through strategies such as maintaining a healthy lifestyle, actively participating in social activities, learning new skills, managing stress, and avoiding anxiety to lay a solid foundation for our health!

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Reference: Yang S, Zhou C, Ye Z, et al. Association Between Cognitive Function and Risk of Chronic Kidney Disease: A Longitudinal Cohort and Mendelian Randomization Study. Mayo Clin Proc. Published online August 6, 2024. doi:10.1016/j.mayocp.2024.04.017

Editor | Yang Sisi Liang Xiaolong

Audit | Qin Xianhui