Impaired renal function is associated with brain atrophy and poststroke cognitive decline

Area of Science:

• Neurology
• Nephrology
• Gerontology

Background:

• Post-stroke cognitive decline is a significant issue.
• Cerebral small vessel disease is implicated in cognitive impairment.
• The relationship between renal function and brain health post-stroke requires further investigation.

Purpose of the Study:

• To investigate the interrelationship between impaired renal function, brain pathology, and cognitive decline in a longitudinal post-stroke cohort.
• To identify if reduced renal function predicts cognitive decline after ischemic stroke.

Main Methods:

• Prospective cohort study of 431 mild-moderate ischemic stroke/TIA survivors without dementia.
• Renal function assessed via creatinine clearance (CCl) at baseline.
• 3T MRI used to measure white matter hyperintensities (WMH), brain atrophy, and hippocampal volume; cognitive assessments conducted over 24 months.

Main Results:

• Participants with CCl <60 mL/min showed significantly worse cognitive performance over time.
• Lower CCl was associated with larger WMH volume and cortical atrophy, and smaller hippocampal volume.
• A baseline CCl <60 mL/min significantly predicted cognitive impairment 2 years post-stroke (OR 2.01).

Conclusions:

• Impaired renal function is associated with brain imaging biomarkers of aging and predicts cognitive decline post-stroke.
• Reduced renal function may be linked to cerebral small vessel disease contributing to cognitive decline.
• Targeting renal function may offer a novel strategy for early intervention in post-stroke cognitive impairment.