Positive correlation between cognitive impairment and renal microangiopathy in patients with type 2 diabetic nephropathy: a multicenter retrospective study

J Int Med Res. 2018 Dec;46(12):5040-5051. doi: 10.1177/0300060518789299. Epub 2018 Sep 12.

Abstract

Objective: This study was performed to explore the correlation between cognitive impairment and renal microangiopathy in patients with type 2 diabetic nephropathy (T2DN) by detecting changes in cognitive function and cerebral metabolism in these patients with different stages of T2DN.

Methods: Prospectively maintained databases were reviewed from 2006 to 2017. Blood biochemical indexes and the urinary albumin excretion rate (UAER) were measured in all participants. Cognitive function was assessed by the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA). Cognitive impairment was the primary endpoint. Renal microangiopathy was the secondary endpoint. Pearson correlation analysis was used to assess correlations.

Results: Two hundred sixteen patients with type 2 diabetes mellitus (T2DM) were divided into three groups according to their UAER: T2DM without nephropathy (n=72), early T2DM with nephropathy (n=74), and the clinical stage of early T2DM with nephropathy (n=70). Healthy participants were selected as the normal control group (n=70). Pearson correlation analysis demonstrated that the total MMSE and MoCA score was negatively correlated with the UAER (r=-0.327) and positively correlated with the estimated glomerular filtration rate (r=0.428) in patients with T2DN.

Conclusions: The present study showed a positive correlation between cognitive impairment and renal microangiopathy in patients with T2DN.

Keywords: Diabetic nephropathy; cognitive impairment; correlation; glomerular filtration rate; renal microangiopathy; urinary albumin excretion rate.

MeSH terms

  • Adult
  • Aged
  • Cognitive Dysfunction / etiology*
  • Cognitive Dysfunction / pathology
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diabetic Nephropathies / complications*
  • Diabetic Nephropathies / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Diseases / etiology*
  • Kidney Diseases / pathology
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Retrospective Studies
  • Thrombotic Microangiopathies / etiology*
  • Thrombotic Microangiopathies / pathology