2024-08-20
Renal failure is significantly associated with an increased risk of Parkinson's disease
Urology-nephrology Neurology
The research article entitled ‘Association between kidney function and Parkinson's disease risk: a prospective study from the UK Biobank’ explores the potential link between kidney function and the risk of developing Parkinson's disease (PD). The study is based on a cohort of 400,571 participants from the UK Biobank, a vast epidemiological database. The researchers used the estimated glomerular filtration rate (eGFR) as an indicator of renal function, calculated from creatinine and cystatin C levels in serum. The aim was to examine whether renal insufficiency, as measured by a reduced eGFR, could be associated with an increased risk of PD.
The researchers used several statistical methods to analyse the data, including Cox regression analyses to assess associations between eGFR and PD risk, and Kaplan-Meier curves to assess the cumulative probability of developing PD over time. In addition, restricted cubic splines (RCS) were used to model the non-linear relationship between eGFR and PD risk.
The study followed participants for a median of 13.8 years, during which time 2,740 cases of PD were recorded. The results showed a significant association between a decrease in eGFR and an increased risk of PD, particularly in participants whose eGFR was less than 30 ml/min/1.73 m². Multivariate analyses confirmed this association after adjustment for various potential confounding factors, such as age, sex, body mass index (BMI), smoking status, and the presence of other chronic diseases such as hypertension and diabetes.
SCR analysis revealed a non-linear relationship between eGFR and the risk of PD, suggesting that the risk increases more markedly when eGFR falls below 60 ml/min/1.73 m². In addition, the study found correlations between changes in eGFR and grey matter volumes in several brain regions, including the frontal cortex, striatum, and cerebellum, areas known to be involved in PD pathology.
These findings supported the hypothesis that chronic kidney disease may play a role in the pathogenesis of PD, potentially as a result of the systemic inflammation and oxidative stress associated with chronic kidney disease (CKD). The researchers suggest that vascular damage and alterations in cerebral haemodynamics, often observed in CKD, could exacerbate neurodegenerative processes, thereby contributing to the development of PD.
The study is distinguished by the use of advanced statistical techniques and a large cohort database, offering a solid perspective on the potential link between renal function and the risk of PD. However, the authors acknowledge certain limitations, in particular the inability to establish a definitive causal relationship due to the observational nature of the study. In addition, the generalisability of the results may be limited to the population studied in the UK Biobank.
These results suggest that kidney health management could be an important preventive measure against PD. The authors call for further research to confirm these associations and explore the underlying biological mechanisms.
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