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Role of Anemia in Dementia Risk Among Veterans With Incident CKD
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12 2023
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Source: Am J Kidney Dis. 82(6):706-714
[PDF-562.45 KB]
Details:
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Alternative Title:Am J Kidney Dis
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Personal Author:
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Description:Rationale & Objective:
While some evidence exists of increased dementia risk from anemia, it is unclear if this association persists among adults with CKD. Anemia may be a key marker for dementia among adults with CKD. We therefore evaluated if anemia is associated with an increased risk of dementia among adults with CKD.
Study Design:
Retrospective cohort study.
Setting & Participants:
The study included 620,095 veterans aged ≥45 years with incident stage 3 CKD (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2) between January 2005 and December 2016 in the US Veterans Health Administration system and followed through December 31, 2018 for incident dementia, kidney failure or death.
Exposures:
Anemia was assessed based on the average of hemoglobin levels (g/L) during the two years prior to the date of incident CKD and categorized as normal, mild and moderate/severe anemia (≥12.0, 11.0–11.9, <11.0 g/dL, respectively for women and ≥13.0, 11.0–12.9, <11.0 g/dL for men).
Outcomes:
Dementia and the composite outcome of kidney failure or death.
Analytical Approach:
Adjusted cause-specific hazard ratios were estimated for each outcome.
Results:
At the time of incident CKD, mean age was 72 years, 97% were male, and mean eGFR was 51 mL/min per 1.73 m2. Over a median 4.1 years of follow-up, 92,306 (15%) veterans developed dementia before kidney failure or death. Compared to veterans with CKD without anemia, multivariable-adjusted models showed a 16% (95% confidence interval [CI] 14% to 17%) significantly higher risk of dementia for those with mild anemia and a 27% (95% CI 23% to 31%) higher risk with moderate/severe anemia. Combined risk of kidney failure or death was higher at 39% (95% CI 37% to 40%) and 115% (95% CI 112% to 119%) for mild and moderate/severe anemia, respectively, compared to no anemia.
Limitations:
Residual confounding from the observational study design. Findings may not be generalizable to the broader U.S. population.
Conclusions:
Anemia was significantly associated with increased risk of dementia among veterans with incident CKD, underscoring the role of anemia as a predictor of dementia risk.
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Source:
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Pubmed ID:37516301
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Pubmed Central ID:PMC10822015
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Document Type:
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Funding:
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Volume:82
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Issue:6
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