While hypertension is a recognized risk factor for dementia and cognitive impairment, there needs to be more data available on the relationship between systolic blood pressure (SBP) and diastolic blood pressure (DBP) and the development of cognitive impairment in chronic kidney disease patients.
A recent study published in the American Journal of Kidney Disease found that higher baseline SBP is associated with a greater risk of cognitive impairment in CKD patients, particularly those who had an estimated glomerular filtration rate (eGFR) greater than 45 mL/min/1.73 m2.

The Chronic Renal Insufficiency Cohort (CRIC) Study involved 3,768 participants. In this Longitudinal cohort study, researchers examined SBP and DBP as exposure variables, utilizing continuous, categorical, and nonlinear terms. The study aimed to establish the association between blood pressure, cognitive impairment, and the severity of decreased kidney function in adults with CKD. The outcome measured was incident cognitive impairment [decline in modified mini-mental state exam (3MS) score].
Key points in the study are:
Participants had a mean age of 58 years with mild-to-moderate CKD and a mean eGFR of 44 Ml/min/1.73 m2.
The median follow-up duration was 11 years.
13.7 % of participants developed cognitive impairment.
Higher baseline systolic blood pressure increases the risk of cognitive impairment.
Compared to patients with advanced CKD, the association was stronger in adults with mild-to-moderate CKD.
Seda Babroudi, MD and colleagues wrote, “In this study, we identified the relationship between blood pressure, cognitive impairment and impaired kidney function.
Researchers revealed that a higher baseline SBP is linked to a greater likelihood of cognitive impairment in those with an estimated glomerular filtration rate (eGFR) of more than 45 mL/min/1.73 m2.
Reference:
Babroudi, Seda, et al. “Blood Pressure, Incident Cognitive Impairment, and Severity of CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study.” American Journal of Kidney Diseases, vol. 82, no. 4, Elsevier BV, Oct. 2023, pp. 443-453.e1. https://doi.org/10.1053/j.ajkd.2023.03.012.