Cognitive Impairment in CKD: Pathophysiology, Management, and Prevention

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
David A DrewMark J Sarnak

Abstract

Patients with chronic kidney disease (CKD) are at substantially higher risk for developing cognitive impairment compared with the general population, and both lower glomerular filtration rate and the presence of albuminuria are associated with the development of cognitive impairment and poorer cognitive function. Given the excess of vascular disease seen in individuals with CKD, cerebrovascular disease is likely the predominant pathology underlying these associations, though impaired clearance of uremic metabolites, depression, sleep disturbance, anemia, and polypharmacy may also contribute. Modification of vascular disease risk factors may be helpful in limiting decline, though definite data are lacking. Specific to CKD, targeting a low blood pressure and reduction in albuminuria with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers may slow cognitive decline, albeit modestly. Initiation of dialysis can improve severe impairment associated with uremia but does not appear to affect more subtle chronic cognitive impairment. In contrast, kidney transplantation appears to lead to improved cognitive function in many transplant recipients, suggesting that dialysis methods do not provide the same cognitive be...Continue Reading

References

Jan 22, 1976·The New England Journal of Medicine·A C AlfreyW D Kaehny
Jul 1, 1982·Journal of Clinical Psychology·G T SouheaverA S DeWolfe
Jul 1, 1997·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·A R SehgalP J Whitehouse
Jul 8, 2000·Kidney International·A K CheungA S Levey
Aug 8, 2001·Seminars in Dialysis·T A Depner
Oct 17, 2001·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·J T Daugirdas
Jul 9, 2003·Kidney International·Stephen L SeligerCatherine O Stehman-Breen
May 20, 2004·Kidney International·Alfred K CheungUNKNOWN HEMO Study Group
Jun 24, 2004·Journal of the American Society of Nephrology : JASN·Stephen L SeligerLew H Kuller
Oct 28, 2004·Journal of the American Geriatrics Society·Manjula KurellaKristine Yaffe
Dec 14, 2004·Journal of Clinical and Experimental Neuropsychology·Nesrine AwadClaude Messier
Apr 9, 2005·Journal of the American Geriatrics Society·Ziad S NasreddineHoward Chertkow
May 13, 2005·Journal of the American Society of Nephrology : JASN·Manjula KurellaKristine Yaffe
Jul 22, 2005·The New England Journal of Medicine·Christoph WannerUNKNOWN German Diabetes and Dialysis Study Investigators
Jun 6, 2006·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Manjula KurellaGlenn M Chertow
Jul 25, 2006·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Konstadina GrivaStanton Peter Newman
Jul 26, 2006·Neurology·A M MurrayR L Kane
Nov 17, 2006·The New England Journal of Medicine·Ajay K SinghUNKNOWN CHOIR Investigators
Aug 11, 2007·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Akira Watanabe
May 13, 2008·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Joshua I BarzilayLewis H Kuller
Jul 1, 2008·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Manjula Kurella TamuraWilliam McClellan
Jul 23, 2008·The Cochrane Database of Systematic Reviews·Maaike AngevarenLuc Vanhees
Dec 17, 2008·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Daniel E WeinerMark J Sarnak
Apr 1, 2009·The New England Journal of Medicine·Bengt C FellströmUNKNOWN AURORA Study Group
Jul 3, 2009·Journal of the International Neuropsychological Society : JINS·Michał HarciarekBolesław Rutkowski
Mar 30, 2010·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Sabin ShurrawUNKNOWN Alberta Kidney Disease Network
Apr 9, 2010·Journal of the American Geriatrics Society·Kristine YaffeUNKNOWN Chronic Renal Insufficiency Cohort Investigators
May 21, 2010·JAMA : the Journal of the American Medical Association·S Susan HedayatiA John Rush
Jun 26, 2010·Clinical Journal of the American Society of Nephrology : CJASN·Manjula Kurella TamuraUNKNOWN Frequent Hemodialysis Network Trial Group
Aug 3, 2010·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Brian T AgganisMark J Sarnak
Oct 12, 2010·Clinical Journal of the American Society of Nephrology : CJASN·Manjula Kurella TamuraAlan S Go
Nov 3, 2010·Seminars in Dialysis·Christopher W McIntyre
Jan 26, 2011·Archives of Internal Medicine·Joshua I BarzilayUNKNOWN ONTARGET and TRANSCEND Investigators
Feb 8, 2011·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Paramjit KaliraoAnne M Murray
Jul 23, 2011·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Daniel E WeinerMark J Sarnak
Feb 23, 2012·Seminars in Dialysis·Mohamed Tarek Eldehni, Christopher W McIntyre
Oct 9, 2012·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·David A DrewMark J Sarnak
Nov 15, 2012·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Manjula Kurella TamuraUNKNOWN Frequent Hemodialysis Network (FHN) Trial Group
Feb 19, 2013·International Psychogeriatrics·Galeno J RojasRicardo F Allegri
Nov 16, 2013·Journal of the American Society of Nephrology : JASN·Tammy L SirichTimothy W Meyer
Dec 18, 2013·Nephron. Clinical Practice·David A DrewMark J Sarnak
May 9, 2014·Journal of the American Society of Nephrology : JASN·Timothy W Meyer, Thomas H Hostetter
Sep 23, 2014·Journal of the American Society of Nephrology : JASN·Mohamed T EldehniChristopher W McIntyre
Sep 23, 2014·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·David A DrewMark J Sarnak

❮ Previous
Next ❯

Citations

Apr 9, 2020·Toxins·Thomas EbertPeter Stenvinkel
May 8, 2020·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Camilla Maroni Marques Freire de MedeirosAlexandre Braga Libório
Apr 3, 2020·Nature Reviews. Nephrology·Davide ViggianoGiovambattista Capasso
Sep 22, 2020·World Journal of Clinical Cases·Yossy MachlufOrna Tal
Dec 9, 2020·Journal of Diabetes and Its Complications·Joshua I BarzilayUNKNOWN GRADE Research Group
Mar 19, 2021·KI Reports·Mark D McCauleyUNKNOWN CRIC Study Investigators
Apr 30, 2021·KI Reports·Maureen MetzgerMi-Kyung Song
May 20, 2021·Journal of Clinical Psychology in Medical Settings·Roland TomasiVera von Dossow
Jun 3, 2021·Journal of Clinical Medicine·Diana Maria AritonPilar Delgado
May 27, 2021·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Euan N PatersonGareth J McKay
Aug 31, 2021·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Tetsuo ShojiMasanori Emoto
Sep 23, 2021·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Jun-Jie ZhuPing Zhou
Nov 6, 2021·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Boris BikbovUNKNOWN CONNECT Action (Cognitive Decline in Nephro-Neurology European Cooperative Target)

❮ Previous
Next ❯

Related Concepts

Related Feeds

Anemia

Anemia develops when your blood lacks enough healthy red blood cells. Anemia of inflammation (AI, also called anemia of chronic disease) is a common, typically normocytic, normochromic anemia that is caused by an underlying inflammatory disease. Here is the latest research on anemia.

Related Papers

Jornal brasileiro de nefrologia : ʹorgão oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Sílvia Mendonça da MattaAna Cristina Simões E Silva
Contributions to Nephrology
Kazuhiko Tsuruya, Hisako Yoshida
Clinical Journal of the American Society of Nephrology : CJASN
Linda Fried
© 2021 Meta ULC. All rights reserved