International Urology and Nephrology

, Volume 50, Issue 8, pp 1505–1510 | Cite as

Kidney function and cognitive decline in frail elderly: two faces of the same coin?

  • Giuseppe Coppolino
  • Davide Bolignano
  • Pietro Gareri
  • Carmen Ruberto
  • Michele Andreucci
  • Giovanni Ruotolo
  • Maurizio Rocca
  • Alberto Castagna
Nephrology - Original Paper


Background and aims

Cognitive and renal impairment are pervasive among elderly frails, a high-risk, geriatric sub-population with peculiar clinical characteristics. In a series of frail individuals with non-advanced chronic kidney disease (CKD), we aimed at assessing the entity of functional, general health and cognitive impairment and the possible relationship between these types of dysfunction and the severity of renal impairment.


2229 geriatric subjects were screened for frailty and CKD. Severity of CKD was assessed by eGFR (CKD-EPI formula). Frailty was established by the Fried Index. Functional, general health and cognitive status were assessed by validated score measures.


Final analysis included 271 frail CKD subjects (162 women, 109 men). Mean eGFR was 64.25 ± 25.04 mL/min/1.73 m2. Prevalence of mild-to-moderate CKD (stage 3–4) was 44%. Twenty-six percent of patients had severe cognitive impairment, while mild and moderate impairment was found in 7 and 67% of individuals, respectively. All subjects had poor functional and general health status. Cognitive capacities significantly decreased across CKD stages (p for trend < 0.0001). In fully adjusted multivariate analyses, cognitive status remained an independent predictor of eGFR (β = 0.465; p < 0.0001).


Mild-to-moderate CKD is highly pervasive among frail elderly individuals and the severity of renal dysfunction is independently correlated with that of cognitive impairment. Future studies are advocated to clarify whether the combination of kidney and mental dysfunction may portend a higher risk of worsen outcomes in this high-risk population.


Frailty CKD Cognitive GFR 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Nephrology and Dialysis Unit“Pugliese-Ciaccio” General HospitalCatanzaroItaly
  2. 2.Institute of Clinical PhysiologyCNR - Italian National Council of ResearchReggio CalabriaItaly
  3. 3.Geriatric Unit“Pugliese-Ciaccio” General HospitalCatanzaroItaly
  4. 4.Renal Unit, Department of Health Sciences“Magna Graecia” UniversityCatanzaroItaly
  5. 5.Center for Cognitive Disorders and DementiaAzienda Sanitaria Provinciale di CatanzaroCatanzaroItaly

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