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Kidney Week

Abstract: PO2461

Endothelial Function, Oxidative Stress, and Cognitive Performance in CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2103 CKD (Non-Dialysis): Mechanisms

Authors

  • Kruse, Nicholas, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, United States
  • Geasland, Katharine M., The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, United States
  • Wu, Chaorong, Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa, United States
  • Linkenmeyer, Carinda, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, United States
  • Ten eyck, Patrick, Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa, United States
  • Hoth, Karin, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, United States
  • Jalal, Diana I., The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, United States
Background

Cognitive impairment, common in patients with chronic kidney disease (CKD), can be explained at least partially by the high prevalence of cerebrovascular disease in the population. Here, we hypothesized that endothelial dysfunction associates with reduced cognition in patients with CKD.

Methods

We conducted a cross-sectional study of 63 middle-aged/older adults with CKD stage 3b and 4. Cognitive function domains including executive function, memory, language, and processing speed were assessed via the NIH-Toolbox. Endothelial function of the brachial artery was assessed via flow-mediated dilation (FMD) using Doppler ultrasound. The influence of oxidative stress on FMD was determined by infusing a supraphysiological dose of ascorbic acid vs. isovolumetric saline (control). Regression models evaluated if measures of vascular function associated with each domain of cognition, and were adjusted for education (< college degree vs. ≥ college degree).

Results

The mean(SD) age, estimated glomerular filtration rate (eGFR), and FMD of the participants were 64(9), 34(11), and 2.6(1.4). Ascorbic acid increased FMD by 4.5±1.7 as compared to saline which increased FMD by 2.5±1.3 (p<0.001). Table 1 illustrates the age-adjusted standard scores for each cognitive domain. We found no association between FMD and any of the cognitive domains. However, a greater response to ascorbic acid correlated with better age-adjusted memory performance independently of education (95% CI: 2.08: 0.51,3.65; p<0.05).

Conclusion

Oxidative stress contributes to endothelial dysfunction in CKD and a greater response to ascorbic acid is associated with better memory performance. More studies are needed to understand the role of oxidative stress in cognitive impairment in patients with stage 3b/4 CKD.

Table 1: NIH Toolbox Cognitive Domain Standard Scores
Executive function95.9±9.5
Memory99.5±10.4
Language100.6±11.1
Processing speed98.8±11.0

Normatively age-adjusted standard sores are presented. Standard scores have a mean of 100 and SD of 15.

Funding

  • Other NIH Support