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We evaluated kidney function in relation to premorbid BP measurements, cerebral small vessel disease (CSVD), and incident mild cognitive impairment (MCI) and dementia in Framingham Offspring Cohort participants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We included Framingham Offspring participants free of dementia, attending an examination during midlife (exam cycle 6, baseline) for ascertainment of kidney function status, with brain magnetic resonance imaging late in life (exam cycles 7\u20139), cognitive outcome data, and available interim hypertension and BP assessments. We related CKD (estimated glomerular filtration rate &amp;lt;60\u00a0ml\/min\/1.73\u00a0m2) and albuminuria (urine albumin-to-creatinine ratio \u226530\u00a0mg\/g) to CSVD markers and cognitive outcomes using multivariable regression analyses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 2604 participants (mean age 67.4\u00a0\u00b1\u00a09.2, 64% women, 7% had CKD, and 9% albuminuria), albuminuria was independently associated with covert infarcts [adjusted OR, 1.55 (1.00\u20132.38); P\u00a0=\u00a00.049] and incident MCI and dementia [adjusted hazard ratio (HR), 1.68 (1.18\u20132.41); P\u00a0=\u00a00.005 and 1.71, (1.11\u20132.64); P\u00a0=\u00a00.015, respectively]. CKD was not associated with CSVD markers but was associated with a higher risk of incident dementia [HR, 1.53 (1.02\u20132.29); P\u00a0=\u00a00.041]. While albuminuria was predictive of the Alzheimer's disease subtype [adjusted HR\u00a0=\u00a01.68, (1.03\u20132.74); P\u00a0=\u00a00.04), CKD was predictive of vascular dementia [adjusted HR, 2.78 (1.16\u20136.68); P\u00a0=\u00a00.023].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Kidney disease was associated with CSVD and cognitive disorders in asymptomatic community dwelling participants. The relation was independent of premorbid BP, suggesting that the link between kidney and brain disease may involve additional mechanisms beyond BP-related injury.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ndt\/gfae079","type":"journal-article","created":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T07:04:39Z","timestamp":1711955079000},"page":"1911-1922","source":"Crossref","is-referenced-by-count":32,"title":["Impaired kidney function, cerebral small vessel disease and cognitive disorders: the Framingham Heart Study"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4318-2030","authenticated-orcid":false,"given":"Dearbhla M","family":"Kelly","sequence":"first","affiliation":[{"name":"J Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adlin A","family":"Pinheiro","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Boston University School of Public Health , Boston, MA ,","place":["USA"]},{"name":"National Heart, Lung, and Blood Institute, Framingham Heart Study , Framingham, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa","family":"Koini","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D","family":"Anderson","sequence":"additional","affiliation":[{"name":"McCance Center for Brain Health, Massachusetts General Hospital , Boston, MA ,","place":["USA"]},{"name":"Program in Medical and Population Genetics, Broad Institute , Cambridge, MA ,","place":["USA"]},{"name":"Department of Neurology, Brigham and Women's Hospital , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Aparicio","sequence":"additional","affiliation":[{"name":"National Heart, Lung, and Blood Institute, Framingham Heart Study , Framingham, MA ,","place":["USA"]},{"name":"Department of Neurology, Boston University Chobanian & Avedisian School of Medicine , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith","family":"Hofer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Graz , Graz ,","place":["Austria"]},{"name":"Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Kern","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Blacker","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Harvard T. H. Chan School of Public Health and Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"DeCarli","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of California, Davis School of Medicine , Sacramento, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Jen","family":"Hwang","sequence":"additional","affiliation":[{"name":"National Heart, Lung, and Blood Institute, Framingham Heart Study , Framingham, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Viswanathan","sequence":"additional","affiliation":[{"name":"J Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitzi M","family":"Gonzales","sequence":"additional","affiliation":[{"name":"The Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Sciences Center , San Antonio, TX ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexa S","family":"Beiser","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Boston University School of Public Health , Boston, MA ,","place":["USA"]},{"name":"National Heart, Lung, and Blood Institute, Framingham Heart Study , Framingham, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudha","family":"Seshadri","sequence":"additional","affiliation":[{"name":"National Heart, Lung, and Blood Institute, Framingham Heart Study , Framingham, MA ,","place":["USA"]},{"name":"The Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, 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