Serum bicarbonate concentration and cognitive function in hypertensive adults

SPRINT Research Group

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background and objectives Cognitive function worsens as kidney function declines, but mechanisms contributing to this association are not completely understood. Metabolic acidosis, a common complication of CKD, leads to neural networks overexcitation and is involved in cerebral autoregulation. We aimed to evaluate the association between serum bicarbonate concentration as a measure of metabolic acidosis, and cognitive function in hypertensive adults with and without CKD. Design, setting, participants, & measurements Five cognitive summary scores were measured (global cognitive function, executive function, memory, attention/concentration, and language) in 2853 participants in the Systolic BP Intervention Trial (SPRINT). Multivariable linear regression models adjusted for demographics, comorbidities, systolic BP, medications, eGFR and albuminuria evaluated the cross-sectional association between bicarbonate and cognition at SPRINT baseline. In a subset (n=681) who underwent brain magnetic resonance imaging, the models were adjusted for white matter hyperintensity volume, vascular reactivity, and cerebral blood flow. Results The mean age (SD) was 68 (8.5) years. Global cognitive and executive functions were positively associated with serum bicarbonate (estimate [SEM]: 0.014 [0.006]; P=0.01, and 0.018 [0.006]; P=0.003, respectively). Each 1 mEq/L lower bicarbonate level had a similar association with global cognitive and executive function as being 4.3 and 5.4 months older, respectively. The association with global cognition persisted after magnetic resonance imaging findings adjustment (estimate [SEM]: 0.03 [0.01]; P=0.01). There was no association between serum bicarbonate level and memory, attention/concentration, and language. Conclusions In a large cohort of hypertensive adults, higher serum bicarbonate levels were independently associated with better global cognitive and executive performance. (ClinicalTrials.gov: NCT01206062).

Original languageEnglish (US)
Pages (from-to)596-603
Number of pages8
JournalClinical Journal of the American Society of Nephrology
Volume13
Issue number4
DOIs
StatePublished - Apr 6 2018
Externally publishedYes

Keywords

  • Acidosis
  • Adult
  • Albuminuria
  • Attention
  • Bicarbonate
  • Bicarbonates
  • Blood pressure
  • Cerebrovascular circulation
  • Chronic
  • Chronic kidney disease
  • Cognition
  • Cognitive function
  • Cohort studies
  • Comorbidity
  • Cross-sectional studies
  • Demography
  • Executive function
  • Homeostasis
  • Humans
  • Language
  • Linear models
  • Magnetic resonance imaging
  • Memory
  • Renal insufficiency
  • White matter

ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

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