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Kidney disease and risk of dementia: A Danish nationwide cohort study

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Objectives It is unclear whether kidney disease is a risk factor for developing dementia. We examined the association between kidney disease and risk of future dementia. Design and setting Nationwide historical registry-based cohort study in Denmark based on data from 1 January 1995 until 31 December 2016. Participants All patients diagnosed with kidney disease and matched general population cohort without kidney disease (matched 1:5 on age, sex and year of kidney disease diagnosis). Primary and secondary outcome measures All-cause dementia and its subtypes: Alzheimer's disease, vascular dementia and other specified or unspecified dementia. We computed 5-year cumulative incidences (risk) and hazard ratios (HRs) for outcomes using Cox regression analyses. Results The study cohort comprised 82 690 patients with kidney disease and 413 405 individuals from the general population. Five-year and ten-year mortality rates were twice as high in patients with kidney disease compared with the general population. The 5-year risk for all-cause dementia was 2.90% (95% confidence interval: 2.78% to 3.08%) in patients with kidney disease and 2.98% (2.92% to 3.04%) in the general population. Compared with the general population, the adjusted HRs for all-cause dementia in patients with kidney disease were 1.06 (1.00 to 1.12) for the 5-year follow-up and 1.08 (1.03 to 1.12) for the entire study period. Risk estimates for dementia subtypes differed substantially and were lower for Alzheimer's disease and higher for vascular dementia. Conclusions Patients diagnosed with kidney disease have a modestly increased rate of dementia, mainly driven by vascular dementia. Moreover, patients with kidney disease may be underdiagnosed with dementia due to high mortality and other comorbidities of higher priority.

OriginalsprogEngelsk
Artikelnummere052652
TidsskriftBMJ Open
Vol/bind11
Nummer10
ISSN2044-6055
DOI
StatusUdgivet - okt. 2021

Bibliografisk note

Funding Information:
Acknowledgements We thank Thomas Bøjer Rasmussen for valuable contributions to the discussion on study design and statistical analyses. Contributors BRJ and CFC had full access to all of the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. ADK and CFC are guarantors of the study. Concept and design: all authors. Statistical analysis: BRJ. Drafting of the manuscript: ADK. Supervision: CFC. Interpretation and critical revision of the manuscript for important intellectual content: all authors. Funding This work was supported by a grant from the Lundbeck Foundation (grant no. R248-2017-521) and from the Independent Research Fund Denmark (grant no. 0134-00407B). ADK is funded by an unrestricted grant from Novo Nordisk (grant no. N/A). VWH is funded by a National Institutes of Health grant (grantno. P30AG066615).

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