The Protective Effects of Insulin on the Developing of Dementia in Chronic Kidney Disease Patients with hypertension and diabetes: A Population-Based Nationwide Study

Abstract

INTRODUCTION: The effects of insulin use on the incidence of dementia in chronic kidney disease (CKD) patients with diabetes and hypertension is limited. METHOD In this retrospective study, differences in the incidence of dementia between insulin users and non-users were examined with competing risk models. RESULTS In a follow-up period of 11 years, 1285 events of dementia were recorded and the multivariate-adjusted hazard ratio for dementia by insulin usage (yes versus non) and insulin usage per medication possession ratio (MPR) is 0.652 (95% confidence interval [CI]: 0.552–0.771) and 0.995 (95% CI: 0.993–0.998) respectively. Such a significantly negative association was consistent in almost the subgroups. Moreover, a dosing effect of insulins was noted that patients who had higher insulin MPRs generally benefited from better protection from dementia. DISCUSSION The CKD patients with hypertension and diabetes who received insulin therapy had a 35% decreased risk of dementia.