CKD Markers Linked to Cognitive Risk

In adults with chronic kidney disease, higher proteinuria and lower estimated glomerular filtration rate are associated with increased risk of incident cognitive impairment.

By
Kathryn Wighton
February 17, 2026
3 min

Conexiant

Overview

A recent study found that patients with chronic kidney disease (CKD) and elevated urinary protein to creatinine ratio (UPCR) have a significantly higher risk of cognitive impairment. Specifically, a 1-standard deviation increase in UPCR was associated with a 21% greater likelihood of attention and processing speed impairment.

Background

Chronic kidney disease (CKD) is a prevalent condition that often goes unnoticed until advanced stages, yet it is linked to various comorbidities, including cognitive decline. Understanding the relationship between kidney function and cognitive health is crucial for early intervention and management strategies. This study highlights the importance of monitoring CKD markers to assess cognitive risk in affected patients.

Data Highlights

CKD Marker	Risk of Cognitive Impairment
UPCR increase (1-SD)	21% greater likelihood of impaired attention and processing speed
eGFR decrease (1-SD)	21% increased likelihood of impaired attention and processing speed (attenuated after UPCR adjustment)
eGFR <60 mL/min/1.73 m² + UPCR ≥150 mg/g	38% higher risk of global cognitive impairment

Key Findings

Patients with eGFR <60 mL/min/1.73 m² and UPCR ≥150 mg/g had a 38% higher risk of global cognitive impairment.
A 1-standard deviation increase in UPCR was linked to a 21% greater likelihood of impaired attention and processing speed.
A 1-standard deviation decrease in eGFR was associated with a 21% increased likelihood of impaired attention and processing speed, but this was attenuated after adjusting for UPCR.
Joint modeling showed complementary associations between eGFR decline and UPCR regarding cognitive impairment.
Exclusion of patients with cognitive impairment at baseline was necessary for longitudinal analyses.

Clinical Implications

Healthcare professionals should consider both eGFR and UPCR when assessing cognitive risk in patients with CKD. Early identification of cognitive impairment can lead to timely interventions that may improve patient outcomes. Monitoring these markers can aid in the stratification of patients for cognitive health assessments.

Conclusion

The findings underscore the critical role of CKD severity in predicting cognitive decline, emphasizing the need for integrated management of kidney health and cognitive function.