Phd ceremony Ms. J.M.H. Joosten: Defining risk factors associated with renal and cognitive dysfunction. Recognizing factors influencing outcome

The worldwide prevalence of risk factors for cardiovascular disease (CVD) rises and they often cluster within subjects. The sum of risk factors indicates an individual’s overall cardiovascular burden and can be calculated with various risk scores. This thesis describes a variety of CVD risk factors which are also associated with poorer cognitive and renal function. Age, smoking and diabetes were identified as overlapping risk factors for brain and kidney dysfunction. These factors were already relevant in young adults. Our research supports the idea that it makes sense to invest in healthy lifestyle and low cardiovascular risk profile; not only for the heart, but also for the kidneys and brain. We subsequently investigated whether cholesterol lowering statin therapy affects cognitive performance. We found no beneficial effect of statin use on cognitive performance. For the future, it is interesting to study whether cognitive function could be protected by preventing or treating other cardiovascular risk factors (in older but also in young people). Furthermore, we showed that patients with renal dysfunction are particularly vulnerable for medication errors. The introduction of an automatically generated alarm towards community pharmacists in case of renal function impairment helped reducing the number of medication errors. Patients with renal dysfunction require extra attention from their doctor and pharmacist to avoid side effects. If (existing) patient data like renal function and medication use would be widely available for different health care providers (in an Electronic Patient Record), this would probably improve medication safety.