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We tested whether kidney function decline affects the predictive accuracy of plasma biomarkers on neuropsychological or neuroimaging outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      Three hundred thirty\u2010three non\u2010demented older adults were included. Linear regressions related plasma glial fibrillary acidic protein, neurofilament light chain (NfL), amyloid beta 42, and phosphorylated tau\n                      <jats:sub>231<\/jats:sub>\n                      , with a blood\u2010based biomarker x estimated glomerular filtration rate (eGFR) interaction term, to cross\u2010sectional and longitudinal (mean follow\u2010up time\u00a0=\u00a06.4\u00a0\u00b1\u00a02.8 years) neuropsychological and neuroimaging outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Plasma NfL interacted with eGFR on the longitudinal trajectory of nearly all neuropsychological outcomes (\n                      <jats:italic>p<\/jats:italic>\n                      values\u00a0&lt;\u00a00.02) and several neuroimaging outcomes (\n                      <jats:italic>p<\/jats:italic>\n                      values\u00a0&lt;\u00a00.02). Associations were stronger in individuals with no CKD\/stage 1 and stage 2 CKD, while associations were weaker or not significant in individuals with stage 3 CKD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Among older adults free of severe CKD, the ability of plasma NfL to predict key AD\u2010related biomarker outcomes was moderated by renal function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Reduced kidney function was associated with increased blood biomarker levels.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>The predictive accuracy of neurofilament light chain was reduced in participants with kidney dysfunction.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Even mild kidney dysfunction can affect blood biomarkers of Alzheimer's disease.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.70651","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T09:46:34Z","timestamp":1758275194000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Mild kidney dysfunction affects the predictive accuracy of blood\u2010based biomarkers for neuropsychological and neuroimaging outcomes over a 9 year follow\u2010up period"],"prefix":"10.1002","volume":"21","author":[{"given":"Corey J.","family":"Bolton","sequence":"first","affiliation":[{"name":"Vanderbilt Memory and Alzheimer's Center Vanderbilt University School of Medicine  Nashville Tennessee USA"},{"name":"Department of Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panpan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Vanderbilt Memory and Alzheimer's Center Vanderbilt University School of Medicine  Nashville Tennessee USA"},{"name":"Department of Biostatistics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devika","family":"Nair","sequence":"additional","affiliation":[{"name":"Vanderbilt Memory and Alzheimer's Center Vanderbilt University School of Medicine  Nashville Tennessee USA"},{"name":"Department of Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Tennessee Valley Veterans Affairs Health System  Nashville Tennessee USA"},{"name":"Veteran Wellbeing through Innovation Systems Science and Experience in Learning Health Systems (VETWISE\u2010LHS) Center of Innovation  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dandan","family":"Liu","sequence":"additional","affiliation":[{"name":"Vanderbilt Memory and Alzheimer's Center Vanderbilt University School of Medicine  Nashville Tennessee USA"},{"name":"Department of Biostatistics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Taylor","family":"Davis","sequence":"additional","affiliation":[{"name":"Vanderbilt Memory and Alzheimer's Center Vanderbilt University School of Medicine  Nashville Tennessee USA"},{"name":"Department of Neurology Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Department of Radiology and Radiological Sciences Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly R.","family":"Pechman","sequence":"additional","affiliation":[{"name":"Vanderbilt Memory and Alzheimer's Center Vanderbilt University School of Medicine  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niranjana","family":"Shashikumar","sequence":"additional","affiliation":[{"name":"Vanderbilt Memory and Alzheimer's Center Vanderbilt University School of Medicine  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Wilhoite","sequence":"additional","affiliation":[{"name":"Vanderbilt Memory and Alzheimer's Center Vanderbilt University School of Medicine  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic","family":"Roby","sequence":"additional","affiliation":[{"name":"Vanderbilt Memory and Alzheimer's Center Vanderbilt University School of Medicine  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlie","family":"Beeson","sequence":"additional","affiliation":[{"name":"Vanderbilt Memory and Alzheimer's Center Vanderbilt University School of Medicine  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haley","family":"Komorowski","sequence":"additional","affiliation":[{"name":"Vanderbilt Memory and Alzheimer's Center Vanderbilt University School of Medicine  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A.","family":"Gifford","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Neurobiology Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J.","family":"Hohman","sequence":"additional","affiliation":[{"name":"Vanderbilt Memory and Alzheimer's Center Vanderbilt University School of Medicine  Nashville Tennessee USA"},{"name":"Department of Neurology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaj","family":"Blennow","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology The Sahlgrenska Academy at University of Gothenburg  Gothenburg Sweden"},{"name":"Clinical Neurochemistry Lab Sahlgrenska University Hospital  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Zetterberg","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology The Sahlgrenska Academy at University of Gothenburg  Gothenburg Sweden"},{"name":"Clinical Neurochemistry Lab Sahlgrenska University Hospital  Gothenburg Sweden"},{"name":"Department of Molecular Neuroscience UCL Institute of Neurology Queen Square  London UK"},{"name":"UK Dementia Research Institute at UCL  London UK"},{"name":"Hong Kong Center for Neurodegenerative Diseases Hong Kong Science Park  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela L.","family":"Jefferson","sequence":"additional","affiliation":[{"name":"Vanderbilt Memory and Alzheimer's Center Vanderbilt University School of Medicine  Nashville Tennessee USA"},{"name":"Department of Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Department of Neurology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008081"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010022\u201001925\u2010w"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD\u2010180325"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.0765"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12756"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010020\u201076990\u20107"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010022\u201001822\u20102"},{"key":"e_1_2_8_9_1","unstructured":"Centers for Disease Control and Prevention.Chronic Kidney Disease in the United States 2023. 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