Table 4:
Cross-sectional Association between Urine Biomarkers of Kidney Tubule Injury and Dysfunction and Measures of Cognitive Function in 2253 SPRINT Participants with CKD
| Biomarker | Digit Symbol Coding (range 0–135) | Logical Memory Test 1 (Immediate Recall) (range 0–28) | 2 (Delayed Recall) (range 0–14) |
|---|---|---|---|
|
B coefficient (95%
CI)
|
|||
| Log 2 IL-18, pg/mL | |||
| Unadjusted | −0.58 (−1.09, −0.07)* | −0.12 (−0.29, 0.06) | −0.04 (−0.16, 0.08) |
| Adjust0EDA | −0.001 (−0.60, 0.59) | −0.07 (−0.31, 0.16) | −0.01 (−0.17, 0.15) |
| Adjusted + eGFR & albuminb | 0.04 (−0.59, 0.67) | −0.10 (−0.35, 0.15) | −0.01 (−0.18, 0.16) |
| Log 2 NGAL, ng/mL | |||
| Unadjusted | −0.74 (−1.12, −0.37)*** | −0.10 (−0.23, 0.03) | −0.03 (−0.12, 0.06) |
| Adjusteda | −0.53 (−0.98, −0.07) | −0.11 (−0.28, 0.07) | −0.04 (−0.16, 0.08) |
| Adjusted + eGFR & albumin | −0.49 (−0.96, −0.02)* | −0.11 (−0.29, 0.07) | −0.04 (−0.16, 0.09) |
| Log 2 YKL-40, pg/mL | |||
| Unadjusted | −0.60 (−0.89, −0.30)*** | −0.07 (−0.18, 0.03) | −0.02 (−0.09, 0.05) |
| Adjusteda | −0.24 (−0.60, 0.11) | −0.01 (−0.15, 0.13) | −0.03 (−0.12, 0.07) |
| Adjusted + eGFR & albumin | −0.27 (−0.63, 0.10) | −0.02 (−0.17, 0.12) | −0.03 (−0.13, 0.07) |
| Log 2 KIM-1, pg/mL | |||
| Unadjusted | −0.27 (−0.69, 0.15) | −0.06 (−0.21, 0.08) | −0.11 (−0.21, 0.01) |
| Adjusteda | −0.47 (−0.96, 0.02) | 0.02 (−0.17, 0.21) | −0.11 (−0.23, 0.03) |
| Adjusted + eGFR & albuminb | −0.41 (−0.92, 0.11) | 0.03 (−0.17, 0.23) | −0.10 (−0.24, 0.03) |
| Log 2 MCP-1, pg/mL | |||
| Unadjusted | −1.12 (−1.61, −0.63)*** | −0.32 (−0.49, −0.15)*** | −0.27 (−0.38, −0.15)*** |
| Adjusteda | −0.56 (−1.13, 0.002) | −0.15 (−0.37, 0.08) | −0.15 (−0.30, 0.003) |
| Adjusted + eGFR & albuminb | −0.55 (−1.14, 0.03) | −0.16 (−0.39, 0.07) | −0.15 (−0.31, 0.004) |
| Log 2 α1M, mg/g | |||
| Unadjusted | −0.91 (−1.43, −0.39)** | −0.37 (−0.55, −0.19)*** | −0.31 (−0.43, −0.19)*** |
| Adjusteda | −0.19 (−0.78, 0.41) | −0.12 (−0.35, 0.11) | −0.07 (−0.23, 0.08) |
| Adjusted + eGFR & albuminb | 0.09 (−0.60, 0.77) | −0.12 (−0.39, 0.15) | −0.07 (−0.25, 0.12) |
| Log 2 β2M, ng/mL | |||
| Unadjusted | −0.43 (−0.67, −0.20)*** | −0.11 (−0.20, −0.03)** | −0.10 (−0.16, −0.04)*** |
| Adjusteda | −0.33 (−0.59, −0.07)* | −0.02 (−0.12, 0.08) | −0.04 (−0.11, 0.03) |
| Adjusted + eGFR & albuminb | −0.29 (−0.56, −0.02)* | −0.01 (−0.12, 0.10) | −0.03 (−0.11, 0.04) |
| Log 2 Umod, ng/mL | |||
| Unadjusted | 1.05 (−0.39, 1.71)** | −0.10 (−0.33, 0.13) | −0.14 (−0.30, 0.02) |
| Adjusteda | 0.04 (−0.73, 0.80) | −0.21 (−0.51, 0.09) | −0.30 (−0.50, −0.10)** |
| Adjusted + eGFR & albuminb | −0.25 (−1.07, 0.56) | −0.30 (−0.62, 0.01) | −0.37 (−0.58, −0.15)** |
| Log 2 albumin, mg/L | |||
| Unadjusted | −0.66 (−0.95, −0.36)*** | −0.17 (−0.28, −0.07)** | −0.14 (−0.21, −0.07)*** |
| Adjusteda | −0.18 (−0.52, 0.15) | −0.01 (−0.14, 0.12) | −0.02 (−0.11, 0.07) |
| Adjusted + eGFR & albuminb | −0.07 (−0.43, 0.28) | 0.02 (−0.12, 0.16) | −0.01 (−0.10, 0.09) |
Note. MoCA, Montreal Cognitive Assessment; IL-18, interleukin-18; KIM-1, kidney injury molecule-1; NGAL, neutrophil gelatinase-associated lipocalin; MCP, monocyte chemoattractant protein-1; β2M, β2-microglobulin; A1M, α1-microglobulin; UMOD, uromodulin.
a
Adjusted for age, race, sex, body mass index, alcohol use, years of education, insurance status, baseline systolic and diastolic blood pressure, smoking status, and urine creatinine
B
Adjusted for all variables listed above and estimated glomerular filtration rate (eGFR) and Log2 albumin.
*
P<0.05;
**
P<0.01;
***
P<0.001