Changes in Alzheimer's disease blood biomarkers in kidney failure before and after kidney transplant.

IF 4 Q1 CLINICAL NEUROLOGY Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Pub Date : 2024-07-03 eCollection Date: 2024-07-01 DOI:10.1002/dad2.12614

Anneka E Blankenship, Lauren Yoksh, Paul J Kueck, Jonathan D Mahnken, Jill K Morris, Aditi Gupta

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Abstract

Introduction: Alzheimer's disease (AD) blood biomarkers show promise for clinical diagnosis but their reliability in chronic kidney disease (CKD) is debated. This study investigates the impact of kidney transplant (KT) on AD biomarkers in CKD.

Methods: We assessed AD biomarkers in 46 CKD patients pre-KT, at 12 weeks and 12 months post-KT, with baseline measures from 13 non-CKD controls. Using linear mixed models, we examined associations with participant groups, estimated glomerular filtration rate (eGFR) and cognition.

Results: CKD patients showed elevated levels of neurofilament light (117 ± 72 vs. 11 ± 5 pg/mL), phosphorylated tau 181 (75 ± 42 vs. 13 ± 8 pg/mL), glial fibrillary acidic protein (193 ± 127 vs. 94 ± 39 pg/mL), amyloid β 42 (17 ± 5 vs. 5 ± 1 pg/mL), and amyloid β 40 (259 ± 96 vs. 72 ± 17 pg/mL) compared to controls. Post-KT, biomarker levels approached normal with improved eGFR, paralleled by enhanced cognitive function.

Discussion: AD blood biomarker elevations in CKD are reversible with improved kidney function through KT.

Highlights: AD biomarker levels are extremely high in severe CKD.AD biomarker levels are higher in patients with kidney failure on dialysis when compared to CKD patients not on dialysis.These elevations in AD biomarker levels in kidney failure are reversable and decrease dramatically after kidney transplantation.The change in biomarker levels after transplantation align with changes in kidney function.The change in biomarker levels after transplantation align with changes in cognitive function.

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肾移植前后肾衰竭患者阿尔茨海默病血液生物标志物的变化。

导言：阿尔茨海默病（AD）血液生物标志物有望用于临床诊断，但其在慢性肾脏病（CKD）中的可靠性还存在争议。本研究探讨了肾移植（KT）对 CKD 阿尔茨海默病生物标志物的影响：我们评估了 46 名 CKD 患者在 KT 前、KT 后 12 周和 12 个月时的注意力缺失生物标志物，以及 13 名非 CKD 对照组的基线测量值。通过线性混合模型，我们研究了与参与者群体、估计肾小球滤过率（eGFR）和认知能力之间的关联：结果：与对照组相比，CKD 患者的神经丝蛋白（117 ± 72 vs. 11 ± 5 pg/mL）、磷酸化 tau 181（75 ± 42 vs. 13 ± 8 pg/mL）、胶质纤维酸性蛋白（193 ± 127 vs. 94 ± 39 pg/mL）、淀粉样β 42（17 ± 5 vs. 5 ± 1 pg/mL）和淀粉样β 40（259 ± 96 vs. 72 ± 17 pg/mL）水平升高。KT后，生物标志物水平接近正常，eGFR改善，认知功能增强：讨论：通过 KT 改善肾功能，CKD 中 AD 血液生物标志物的升高是可逆的：肾脏移植后生物标志物水平的变化与肾功能的变化相一致。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Medicine-Psychiatry and Mental Health

CiteScore

7.80

自引率

7.50%

发文量

101

审稿时长

8 weeks

期刊介绍： Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.