Chronic kidney disease in patients with cognitive impairment: A marker of microvascular damage or an independent risk factor?

Evaluation of: Yaffe K, Ackerson L, Tamura MK et al.: Chronic kidney disease and cognitive function in older adults: findings from the chronic renal insufficiency cohort cognitive study. J. Am. Geriatr. Soc. 58, 338-345 (2010). The effect of chronic kidney disease (CKD) on cognition is unclear, especially in less severe forms of the disease. Studies are needed to clarify whether CKD is associated with a particular pattern of cognitive dysfunction, to understand the cognitive domains affected, and to clarify the mechanisms through which CKD might be affecting brain function. The authors comment on a cross-sectional study in a well-characterized cohort of patients with CKD that examined the effect of different levels of kidney function on cognitive impairment. The methodology of the study and the potential mechanisms underlying cognitive impairment seen in patients with CKD are discussed.