Kidney Week

Abstract: TH-PO678

Dietary Sodium Intake and Cognitive Impairment in the Chronic Renal Insufficiency Cohort (CRIC)

Session Information

• Hypertension and CVD: Epidemiology, Risk Factors
  November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

• Nowak, Kristen L., University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Kristen L. Nowak,

• You, Zhiying, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Zhiying You,

• Jovanovich, Anna Jeanette, Denver VA Medical Center, Denver, Colorado, United States

Anna Jeanette Jovanovich,

• Chonchol, Michel, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Michel Chonchol,

Background

Cognitive dysfunction is a well-documented occurrence in individuals with chronic kidney disease (CKD), affecting multiple domains of cognitive function. Dietary sodium may influence cognitive function via effects on cerebrovascular function and cerebral blood flow. We hypothesized that high dietary sodium intake, as measured by 24-hr urine sodium excretion, is as associated with a decline in cognitive function over time in adults with CKD.

Methods

1,724 participants in the observational cohort study, CRIC, with measurement of 24-hr urine sodium excretion, and modified mini mental state exam (3MS) score at baseline and year 4, who were free from baseline cognitive dysfunction were included. Multivariable logistic regression was used to examine the association between baseline 24-hr urine sodium excretion and odds of incident cognitive impairment, defined as a decline 3MS score ≥1.0 SD below the mean change in completion score (mean±SD for change in 3MS score was -0.26±5.08). High baseline sodium intake was defined as excretion >150 mmol/d.

Results

Participants were 59±11 years, baseline estimated glomerular filtration rate (eGFR) was 45±13 ml/min/1.73m², and baseline 24-hr sodium excretion was 164±76 mmol/d. During follow-up of 4.1±0.2 years, 185 CRIC participants (11%) had a clinically significant decline in 3MS score (i.e. incident cognitive impairment). After adjustment for demographics, clinic site, smoking, body-mass index, eGFR, cardiovascular risk factors, physical activity, systolic blood pressure, and 24-hr urine protein, potassium, and creatinine, high baseline dietary sodium intake was associated with increased odds of incident cognitive impairment (OR: 1.56, 95% CI: 1.08-2.27 vs low sodium intake).

Conclusion

In adults with CKD who participated in CRIC, higher sodium intake was independently associated with increased odds of incident cognitive impairment.