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Intensive blood pressure control and cognitive impairment in chronic kidney disease: The jury is still out

      Globally, 55 million people suffer from dementia, mainly Alzheimer's disease (60–70% of cases), and over 60% of patients live in low- or middle-income countries. This number is estimated to rise to 78 million in 2030 and 139 million in 2050, and over 70% of new cases will occur in poorer countries, with huge socioeconomic costs for affected individuals, their relatives, and governments [
      World Health Organization SG
      ]. People with chronic kidney disease (CKD), as defined by an estimated glomerular filtration rate [eGFR] lower than 60 mL/min/1.73 m2, or eGFR ≥ 60 plus a marker of kidney damage (albuminuria, abnormal kidney ultrasound scan, etc.) [
      • Stevens P.E.
      • Levin A.
      Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline.
      ] have a significantly higher risk for cognitive impairment compared to the general population [
      • Drew D.A.
      • Weiner D.E.
      • Sarnak M.J.
      Cognitive impairment in CKD: pathophysiology, management, and prevention.
      ]. As the global prevalence of CKD is as high as 13.4% (i.e. over 700 million people) [
      • Hill N.R.
      • Fatoba S.T.
      • Oke J.L.
      • Hirst J.A.
      • O’Callaghan C.A.
      • Lasserson D.S.
      • et al.
      Global prevalence of chronic kidney disease - a systematic review and meta-analysis.
      ], it is hardly surprising that there is a great interest in the primary and secondary prevention of dementia worldwide.
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