CHRONIC KIDNEY DISEASE has been associated with greater post-stroke cognitive decline, according to new evidence from Seoul, Republic of Korea.
The findings come from a retrospective population-based study of 359,572 individuals who underwent repeated standardised cognitive assessments.
Researchers examined data from the Korean National Health Insurance Service and Long-Term Care Insurance databases. Changes in cognitive function were evaluated using repeated cognitive function equivalent score assessments.
Participants were categorised according to chronic kidney disease (CKD) status and stroke timing, allowing investigators to assess whether kidney disease significantly affected the trajectory of cognitive decline after stroke.
Stroke Survivors with CKD Face Faster Cognitive Decline
CKD alone was associated with a moderately faster rate of cognitive decline compared with individuals without CKD or stroke.
Pre-existing stroke alone was not significantly associated with accelerated decline, but when CKD co-existed with pre-existing stroke, the association increased substantially.
Incident stroke was also linked to faster deterioration in cognitive function. The effect was numerically greater among individuals with both chronic kidney disease and incident stroke.
The largest effect size was observed in participants with recurrent stroke and CKD.
Evidence of a Stroke-Specific Effect
A significant positive interaction was identified between CKD and pre-existing stroke on the continuous cognitive outcome scale.
Interactions involving incident and recurrent stroke showed similar directional trends but did not achieve statistical significance.
When clinically significant cognitive decline was assessed, the combination of CKD and incident stroke produced the highest risk, exceeding the risk associated with incident stroke alone.
Findings Not Replicated in Neurodegenerative Disease
Secondary analyses explored whether CKD similarly amplified cognitive decline in dementia and Parkinson’s disease.
No consistent acceleration of cognitive decline was observed when CKD co-occurred with these neurodegenerative conditions.
Interaction estimates were either null or negative, suggesting the observed association may be more specific to vascular disease processes than to neurodegeneration.
While evidence for interaction varied across analytical approaches, the findings indicate that individuals with CKD who experience stroke may represent a population at increased risk of accelerated cognitive deterioration and may warrant closer cognitive monitoring.
Reference
Kim HJ et al. Chronic kidney disease is associated with greater post-stroke cognitive decline in a nationwide longitudinal cohort. Sci Rep. 2026;DOI:10.1038/s41598-026-60509-7
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