Kidney Function and Blood and Cerebrospinal Fluid Biomarkers in Alzheimer's Disease and Related Dementias: Systematic Review and Meta-Analysis.

Associations between kidney function and cerebrospinal fluid biomarkers for Alzheimer's disease and related dementia were heterogeneous and NS.

肾功能与阿尔茨海默病及相关痴呆的脑脊液生物标志物之间的关联是异质性的，并且无统计学意义（NS）。

Elevated blood biomarkers for Alzheimer's disease and related dementia in people with impaired kidney function may reflect reduced kidney clearance.

在肾功能受损的人群中，阿尔茨海默病及相关痴呆的血液生物标志物水平升高可能反映了肾脏清除能力的降低。

Background

Studies have shown that low kidney function may link to elevated Alzheimer's disease and related dementia fluid biomarkers, but the results are not consistent.

研究表明，低肾功能可能与阿尔茨海默病及相关痴呆的液体生物标志物水平升高有关，但结果并不一致。

This systematic reviewand meta-analysisaimed to investigate whether kidney function was associated with Alzheimer's disease and related dementia biomarkers (amyloid- β , tau, neurofilament light [NfL] protein, and glial fibrillary acidic protein [GFAP]) in blood and cerebrospinal fluid (CSF).

本系统评价和荟萃分析旨在调查肾功能是否与阿尔茨海默病及相关痴呆生物标志物（淀粉样蛋白-β，tau蛋白，神经丝轻链[NfL]蛋白和胶质纤维酸性蛋白[GFAP]）在血液和脑脊液中的关联。

Methods

Human studies were identified through MEDLINE, EMBASE, Cochrane Library, and Web of Science (until May 2, 2025).

通过MEDLINE、EMBASE、Cochrane图书馆和Web of Science（截至2025年5月2日）识别了人类研究。

Studies that reported the association between kidney function and Alzheimer's disease and related dementia biomarkers in blood or CSF among adults were included.

纳入了报告成人肾功能与血液或脑脊液中阿尔茨海默病及相关痴呆生物标志物之间关联的研究。

Two authors independently screened and extracted data following preferred reporting items for systematic reviews and meta-analyses 2020 guidelines.

两位作者独立地根据2020年系统评价和荟萃分析优先报告项目指南进行了筛选和数据提取。

Descriptive statistics and random-effects meta-analysiswere used to analyze pooled effects.

使用描述性统计和随机效应的荟萃分析来分析汇总效应。

Results

Of the 3024 studies screened, 93 met the inclusion criteria, encompassing 62,503 participants (mean age, 20-96 years; 54% female) from 21 countries.

在筛选的3024项研究中，有93项符合纳入标准，涵盖了来自21个国家的62,503名参与者（平均年龄20-96岁；54%为女性）。

Ninety-one studies reported blood biomarkers, while ten reported CSF biomarkers.

91项研究报告了血液生物标志物，而10项报告了脑脊液生物标志物。

In meta-analysisof unadjusted correlation coefficients, kidney function (primarily eGFR) was inversely associated with concentrations of blood NfL, GFAP, Aβ40, β-amyloid 1-40 (A β 40), β-amyloid 1-42, and phosphorylated tau (p-tau181).

在未调整相关系数的荟萃分析中，肾功能（主要是eGFR）与血液中NfL、GFAP、Aβ40、β-淀粉样蛋白1-40（Aβ40）、β-淀粉样蛋白1-42和磷酸化tau（p-tau181）的浓度呈负相关。

In meta-analysisof adjusted regression coefficients, eGFR remained inversely associated with blood biomarker levels.

在调整回归系数的荟萃分析中，eGFR与血液生物标志物水平呈负相关。

Specifically, every 1 ml/min per 1.73 m 2 lower eGFR was associated with 0.19 pg/ml higher NfL (95% confidence interval[CI], 0.12 to 0.25), 0.11 pg/ml higher GFAP (95% CI, 0.04 to 0.18), and 0.29 pg/ml higher A β 40 (95% CI, 0.01 to 0.56).

具体来说，每降低1 ml/min/1.73 m2的eGFR，与NfL水平升高0.19 pg/ml (95%置信区间[CI], 0.12至0.25)、GFAP水平升高0.11 pg/ml (95% CI, 0.04至0.18)以及Aβ40水平升高0.29 pg/ml (95% CI, 0.01至0.56)相关。

CSF biomarker findings were more heterogeneous and generally null.

CSF生物标志物的发现更为异质，总体上没有显著性。

Conclusions

Low kidney function was associated with elevated blood biomarkers of Alzheimer's disease and related dementia (NfL, GFAP, and A β 40), whereas associations with CSF biomarkers were inconsistent and generally null.

低肾功能与阿尔茨海默病及相关痴呆的血液生物标志物（NfL、GFAP和Aβ40）升高有关，而与CSF生物标志物的关联不一致，总体上没有显著性。