Kidney Function Impacts Plasma Alzheimer’s Biomarkers In A Cognitively Normal Multi-Ethnic Cohort

Author(s): James R. Hall, Melissa Petersen, Leigh A Johnson & Sid O’Bryant for the HABS-HD Study Team

Background: Plasma biomarkers of Alzheimer’s disease (AD) can be cost-effective, non-invasive, scalable measures for screening into clinical research and trials. Little research has examined the impact of medical comorbidities on these biomarkers especially among underserved communities. The current study examined the impact of kidney functioning on plasma AD biomarkers among a multi-ethnic cohort.

Methods: 1,328 cognitively unimpaired Mexican American (659) and non-Hispanic white (669) participants were examined. eGFR levels were categorized into eGFR1>=90 (normal kidney function), eGFR2 61-89 (mild kidney function loss) and eGFR3 ≤60 (moderate to severe kidney function loss). Aβ40, Aβ42, total tau and NfL were assayed using Simoa.

Results: Mild and moderate/severe eGFR levels, were associated with all plasma biomarkers. For Mexican Americans, mild and moderate/severe kidney function loss was associated with Aβ40, Aβ42, total tau and NfL. Among non-Hispanic whites, mild kidney function loss was associated with Aβ40 and Aβ42 whereas moderate/severe kidney function loss was associated with all biomarkers.

Conclusion: Among cognitively normal adults, even mild kidney loss is associated with alterations in the plasma AD biomarkers. Additional work to determine how to consider eGFR levels best to avoid misdiagnosis and inappropriate referrals for more invasive, and costly, procedures based on plasma biomarker findings is needed.

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