Polycystic kidney disease is significantly associated with dementia risk

Tung-Min Yu; Ya-Wen Chuang; Kuo-Ting Sun; Mei-Ching Yu; Shiang-Cheng Kung; Brian K Lee; Shih-Ting Huang; Cheng-Hsu Chen; Cheng-Li Lin; Chia-Hung Kao

doi:10.1212/WNL.0000000000004434

Polycystic kidney disease is significantly associated with dementia risk

Neurology. 2017 Oct 3;89(14):1457-1463. doi: 10.1212/WNL.0000000000004434. Epub 2017 Aug 30.

Authors

Affiliations

¹ From the Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine (T.-M.Y., K.-T.S., S.-T.H., C.-H.C., C.-H.K.), Pediatric Dentistry, Dental Department (K.-T.S.), and College of Medicine (C.-L.L.), China Medical University, Taichung; Division of Nephrology (T.-M.Y., Y.-W.C., S.-T.H., C.-H.C.) and Department of Medical Research and Center of Quality Management (C.-H.C.), Taichung Veterans General Hospital, Taiwan; Connie Frank Transplant Center, Division of Nephrology, Department of Medicine (S.-C.K., B.K.L.), UCSF Medical Center, San Francisco, CA; Department of Pediatrics, Division of Nephrology (M.-C.Y.), Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan; Department of Life Science (C.-H.C.), Tunghai University; Management Office for Health Data (C.-L.L.) and Department of Nuclear Medicine and PET Center (C.-H.K.), China Medical University Hospital; and Department of Bioinformatics and Medical Engineering (C.-H.K.), Asia University, Taichung, Taiwan.
² From the Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine (T.-M.Y., K.-T.S., S.-T.H., C.-H.C., C.-H.K.), Pediatric Dentistry, Dental Department (K.-T.S.), and College of Medicine (C.-L.L.), China Medical University, Taichung; Division of Nephrology (T.-M.Y., Y.-W.C., S.-T.H., C.-H.C.) and Department of Medical Research and Center of Quality Management (C.-H.C.), Taichung Veterans General Hospital, Taiwan; Connie Frank Transplant Center, Division of Nephrology, Department of Medicine (S.-C.K., B.K.L.), UCSF Medical Center, San Francisco, CA; Department of Pediatrics, Division of Nephrology (M.-C.Y.), Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan; Department of Life Science (C.-H.C.), Tunghai University; Management Office for Health Data (C.-L.L.) and Department of Nuclear Medicine and PET Center (C.-H.K.), China Medical University Hospital; and Department of Bioinformatics and Medical Engineering (C.-H.K.), Asia University, Taichung, Taiwan. d10040@mail.cmuh.org.tw.

PMID: 28855402
DOI: 10.1212/WNL.0000000000004434

Abstract

Objective: Data on the risk of neurodegenerative diseases, including Alzheimer disease (AD) and Parkinson disease (PD), in patients with polycystic kidney disease (PKD) are lacking.

Methods: A total of 4,229 patients who were aged ≥20 years and had received a diagnosis of PKD were included in the PKD cohort. For each PKD case identified, 1 participant aged ≥20 years without a history of PKD, dementia, or PD was selected from the comparison cohort. For each patient with PKD, the corresponding controls were selected 1:1 on the basis of the nearest propensity score calculated using logistic regression.

Results: The incidence density rates of dementia were 4.31 and 2.50 per 1,000 person-years in the PKD and control cohorts, respectively. A 2.04-fold higher risk of dementia was observed in patients with PKD than in controls (adjusted hazard ratio [aHR] 2.04; 95% confidence interval [CI] 1.46-2.85). Regarding the risk of different dementia subtypes, including AD and vascular dementia (VaD), the aHR for AD and presenile dementia was 2.71 (95% CI 1.08-6.75) and that for VaD was 0.90 (95% CI 0.43-1.87) in patients with PKD compared with controls, after adjustment for age, sex, and comorbidities. Compared with controls, the risk of PD increased by 1.78-fold (95% CI 1.14-2.79) in patients with PKD.

Conclusions: In clinical practice, health care professionals should be aware of the risk of neurodegenerative diseases in patients with PKD.

MeSH terms

Age Factors
Aged
Cohort Studies
Comorbidity
Dementia / classification
Dementia / epidemiology*
Female
Humans
Incidence
Male
Middle Aged
Mutation / genetics
Polycystic Kidney Diseases / epidemiology*
Polycystic Kidney Diseases / genetics
Proportional Hazards Models
Risk Factors
TRPP Cation Channels / genetics

Substances

TRPP Cation Channels
polycystic kidney disease 1 protein