Albuminuria Linked to Increased Risk of Dementia, independent of baseline eGFR: Study
According to a recent study, higher levels of albuminuria are associated with an increased risk of all-cause dementia, especially mixed, vascular, and unspecified subtypes. This association is independent of baseline eGFR and remains consistent across different clinical pathways used for albuminuria testing. The study was published in the Journal of Internal Medicine by Li Luo and colleagues.
Albuminuria, considered an index of damaged kidneys and systemic vascular function, was not clearly associated with the development of dementia in earlier studies. There was a lack of consideration of different types of dementia and interactions between albuminuria and estimated glomerular filtration rate (eGFR). Also, different approaches to albuminuria testing might have obscured knowing whether albuminuria, defined by urine albumin–creatinine ratio (ACR) or dipsticks, raises the risk of incident dementia independently of eGFR and whether this risk varies by different types of dementia.
It was an observational cohort study that used information from a database established by the Stockholm Creatinine Measurements (SCREAM) project. It spanned from 2006 to 2019. It included 132,869 adults aged 65 years and over who had not previously been diagnosed with dementia and who had an ACR recorded.
Key findings
• Over a median follow-up of 3.9 years (interquartile range, 1.8–7.1 years), 9435 participants (7%) developed incident dementia
Compared with ACR <30 mg/g:
• ACR 30–299 mg/g was associated with a 25% higher risk of all-cause dementia (HR 1.25, 95% CI 1.19–1.31)
• ACR ≥300 mg/g was associated with a 37% higher risk (HR 1.37, 95% CI 1.23–1.51)
Higher ACR levels were significantly associated with increased risks of:
• Vascular dementia
• Mixed dementia
• Unspecified dementia
• No significant association was observed between albuminuria and Alzheimer’s disease
Higher levels of albuminuria in older adults without previous dementia are associated with an increased risk of all-cause dementia, especially vascular, mixed, and unspecified dementia, independently of baseline eGFR. These findings support albuminuria as a clinically accessible marker of dementia risk and add weight to the concept of shared vascular mechanisms that link kidney and brain health.
Reference:
Luo, L., Gansevoort, R. T., Kieneker, L. M., Yang, Y., Bosi, A., de Boer, R. A., Franssen, C. F. M., Eriksdotter, M., Carrero, J.-J., & Xu, H. (2025). Albuminuria is associated with increased risk of dementia, independent of eGFR: The SCREAM project. Journal of Internal Medicine, 298(5), 489–503. https://doi.org/10.1111/joim.70022
