SEATTLE — A new study in the Clinical Journal of the American Society of Nephrology suggests that those who get an acute injury of the kidney during their hospital stay due to a heart or lung condition may be at risk of reduced mental acuity.
The study, led by the University of Washington (UW) Medicine, followed 1,538 patients after their hospitalization and performed cognitive tests at three, 12 and 24 months.
“For the last two or three decades, there has been a growing recognition and concern of the long-term physical and cognitive consequences after hospitalization,” said lead author Dr. Pavan Bhatraju, a UW Medicine pulmonologist and critical-care specialist. “Caring for patients in the hospital, we have noticed some patients have declines in cognitive function after leaving the hospital and we were wondering why this happens.”
This led the team to look into the kidneys for injuries, due to their role in removing toxins from the body, as a potential risk factor that might result in an inflammatory reaction in the brain, said Bhatraju.
“We know that it happens,” Bhatraju said. “Now we want to know why it occurs and how to prevent it.”
Researchers selected inpatients at UW Medicine, Vanderbilt University, Kaiser Permanente and Yale University for this study.
Looking for biomarkers that appeared when the inflammation was discovered, researchers found higher levels in those who had acute kidney injury.
During cognitive tests, participants with acute kidney injury scored below 85 on average, on a scale of 0 to 100. This was lower than the average scores of 92-93 for those without acute kidney injury.
Although the scores don’t directly link acute kidney injury and loss of cognitive function, researchers will look for ways to treat patients after such an event to prevent cognitive loss.
“We don’t know for certain that AKI can lead to brain dysfunction,” Bhatraju said. “That is what we want to study next.”
The study concludes that further work is needed to determine causality or is a marker for cognitive impairment.
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