Abstract：
BACKGROUND: Clonal hematopoiesis of indeterminate potential (CHIP) and dementia disproportionately burden patients with chronic kidney disease (CKD). The association between CHIP and cognitive impairment in CKD patients is unknown.
METHODS: We conducted time-to-event analyses in up to 1452 older adults with CKD from the Chronic Renal Insufficiency Cohort who underwent CHIP gene sequencing. Cognition was assessed using four validated tests in up to 6 years mean follow-up time. Incident cognitive impairment was defined as a test score one standard deviation below the baseline mean.
RESULTS: Compared to non-carriers, CHIP carriers were markedly less likely to experience impairment in attention (adjusted hazard ratio [HR] [95% confidence interval {CI}] = 0.44 [0.26, 0.76], p = 0.003) and executive function (adjusted HR [95% CI] = 0.60 [0.37, 0.97], p = 0.04). There were no significant associations between CHIP and impairment in global cognition or verbal memory.
CONCLUSIONS: CHIP was associated with lower risks of impairment in attention and executive function among CKD patients.
CONCLUSIONS: Our study is the first to examine the role of CHIP in cognitive decline in CKD. CHIP markedly decreased the risk of impairment in attention and executive function. CHIP was not associated with impairment in global cognition or verbal memory.
METHODS: We conducted time-to-event analyses in up to 1452 older adults with CKD from the Chronic Renal Insufficiency Cohort who underwent CHIP gene sequencing. Cognition was assessed using four validated tests in up to 6 years mean follow-up time. Incident cognitive impairment was defined as a test score one standard deviation below the baseline mean.
RESULTS: Compared to non-carriers, CHIP carriers were markedly less likely to experience impairment in attention (adjusted hazard ratio [HR] [95% confidence interval {CI}] = 0.44 [0.26, 0.76], p = 0.003) and executive function (adjusted HR [95% CI] = 0.60 [0.37, 0.97], p = 0.04). There were no significant associations between CHIP and impairment in global cognition or verbal memory.
CONCLUSIONS: CHIP was associated with lower risks of impairment in attention and executive function among CKD patients.
CONCLUSIONS: Our study is the first to examine the role of CHIP in cognitive decline in CKD. CHIP markedly decreased the risk of impairment in attention and executive function. CHIP was not associated with impairment in global cognition or verbal memory.
摘要：
背景：不确定潜能（CHIP）和痴呆的克隆造血给慢性肾病（CKD）患者带来不成比例的负担。CHIP与CKD患者认知障碍之间的关系尚不清楚。
方法：我们在接受CHIP基因测序的慢性肾功能不全队列中，对多达1452名CKD老年患者进行了时间-事件分析。在长达6年的平均随访时间内，使用四个经过验证的测试来评估认知。意外认知障碍定义为测试评分低于基线平均值一个标准偏差。
结果：与非运营商相比，CHIP携带者明显不太可能出现注意力障碍（调整后的风险比[HR][95%置信区间{CI}]=0.44[0.26,0.76]，p=0.003)和执行功能(调整后的HR[95%CI]=0.60[0.37，0.97]，p=0.04)。CHIP与整体认知或言语记忆障碍之间没有显着关联。
结论：CHIP与CKD患者注意力和执行功能受损的风险较低相关。
结论：我们的研究首次探讨了CHIP在CKD认知衰退中的作用。CHIP显著降低了注意力和执行功能受损的风险。CHIP与整体认知或言语记忆障碍无关。
方法：我们在接受CHIP基因测序的慢性肾功能不全队列中，对多达1452名CKD老年患者进行了时间-事件分析。在长达6年的平均随访时间内，使用四个经过验证的测试来评估认知。意外认知障碍定义为测试评分低于基线平均值一个标准偏差。
结果：与非运营商相比，CHIP携带者明显不太可能出现注意力障碍（调整后的风险比[HR][95%置信区间{CI}]=0.44[0.26,0.76]，p=0.003)和执行功能(调整后的HR[95%CI]=0.60[0.37，0.97]，p=0.04)。CHIP与整体认知或言语记忆障碍之间没有显着关联。
结论：CHIP与CKD患者注意力和执行功能受损的风险较低相关。
结论：我们的研究首次探讨了CHIP在CKD认知衰退中的作用。CHIP显著降低了注意力和执行功能受损的风险。CHIP与整体认知或言语记忆障碍无关。
