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https://www.readbyqxmd.com/read/27867500/neurological-complications-in-chronic-kidney-disease
#1
REVIEW
Ria Arnold, Tushar Issar, Arun V Krishnan, Bruce A Pussell
Patients with chronic kidney disease (CKD) are frequently afflicted with neurological complications. These complications can potentially affect both the central and peripheral nervous systems. Common neurological complications in CKD include stroke, cognitive dysfunction, encephalopathy, peripheral and autonomic neuropathies. These conditions have significant impact not only on patient morbidity but also on mortality risk through a variety of mechanisms. Understanding the pathophysiological mechanisms of these conditions can provide insights into effective management strategies for neurological complications...
January 2016: JRSM Cardiovascular Disease
https://www.readbyqxmd.com/read/27861242/higher-cystatin-c-levels-are-associated-with-neurocognitive-impairment-in-older-hiv-adults
#2
Marissa E Sakoda, Pariya L Fazeli, Ronald J Ellis, Dilip V Jeste, Igor Grant, Scott L Letendre, David J Moore
OBJECTIVE: The study aims to determine whether cystatin C is associated with HIV disease and HIV-associated neurocognitive impairment (NCI). METHODS: Participants included 124 (HIV+ n = 77; HIV- n = 47) older adults (age ≥ 50 years) examined at the UCSD HIV Neurobehavioral Research Program. Cystatin C, a biomarker of kidney functioning that has been linked to poor health outcomes, was measured in blood. Participants completed a comprehensive neurocognitive assessment that was used to define both global and domain NCI...
November 15, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27861179/cognitive-impairment-and-dementia-in-older-adults-with-chronic-kidney-disease-a-review
#3
Andrea R Zammit, Mindy J Katz, Markus Bitzer, Richard B Lipton
Individuals with chronic kidney disease (CKD), especially older adults, are at more risk of experiencing cognitive impairment, possibly leading to mild cognitive impairment and/or dementia. Studies report associations between CKD and cognitive impairment; although unclear, there seems to be a graded association between stage of CKD and affected cognitive domains, with executive function being affected earlier in the process than episodic memory and global ability. In CKD, dysexecutive mild cognitive impairment and vascular dementia are also more prominent than other subtypes...
October 2016: Alzheimer Disease and Associated Disorders
https://www.readbyqxmd.com/read/27835681/cognitive-performance-is-highly-stable-over-a-2-year-follow-up-in-chronic-kidney-disease-patients-in-a-dedicated-medical-environment
#4
Janine Gronewold, Olga Todica, Ulla K Seidel, Michaela Volsek, Andreas Kribben, Heike Bruck, Dirk M Hermann
BACKGROUND: As kidney and brain functions decline with aging, chronic kidney disease (CKD) and dementia are becoming increasing health burdens worldwide. Among the risk factors for cognitive impairment, CKD is increasingly recognized. The precise impact of CKD on the development of cognitive impairment is poorly understood. METHODS: In the New Tools for the Prevention of Cardiovascular Disease in Chronic Kidney Disease (NTCVD) cohort, which was recruited in a dedicated nephrology department, we examined the 2-year course of cognitive performance in 120 patients (73 patients with CKD stages 3-5D, 47 control patients without CKD with similar vascular risk profile) using a comprehensive battery of 10 neuropsychological tests...
2016: PloS One
https://www.readbyqxmd.com/read/27798938/cognitive-impairment-in-advanced-chronic-kidney-disease-the-canadian-frailty-observation-and-interventions-trial
#5
Rukhsana Foster, Simon Walker, Ranveer Brar, Brett Hiebert, Paul Komenda, Claudio Rigatto, Leroy Storsley, Bhanu Prasad, Clara Bohm, Navdeep Tangri
BACKGROUND: Chronic kidney disease (CKD) affects more than one third of older adults, and is a strong risk factor for vascular disease and cognitive impairment. Cognitive impairment can have detrimental effects on the quality of life through decreased treatment adherence and poor nutrition and results in increased costs of care and early mortality. Though widely studied in hemodialysis populations, little is known about cognitive impairment in patients with pre-dialysis CKD. METHODS: Multicenter, cross-sectional, prospective cohort study including 385 patients with CKD stages G4-G5...
November 1, 2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27769903/pre-existing-risk-factors-for-in-hospital-death-among-older-patients-could-be-used-to-initiate-end-of-life-discussions-rather-than-rapid-response-system-calls-a-case-control-study
#6
Magnolia Cardona-Morrell, Amanda Chapman, Robin M Turner, Ebony Lewis, Blanca Gallego-Luxan, Michael Parr, Ken Hillman
AIM: To investigate associations between clinical parameters - beyond the evident physiological deterioration and limitations of medical treatment - with in-hospital death for patients receiving Rapid Response System (RRS) attendances. METHODS: Retrospective case-control analysis of clinical parameters for 328 patients aged 60 years and above at their last RRS call during admission to a single teaching hospital in the 2012-2013 calendar years. Generalised estimating equation modelling was used to compare the deceased with a randomly selected sample of those who had RRS calls and survived admission (controls), matched by age group, sex, and hospital ward...
December 2016: Resuscitation
https://www.readbyqxmd.com/read/27767995/association-of-kidney-function-biomarkers-with-brain-mri-findings-the-brink-study
#7
Prashanthi Vemuri, David S Knopman, Clifford R Jack, Emily S Lundt, Stephen D Weigand, Samantha M Zuk, Kaely B Thostenson, Robert I Reid, Kejal Kantarci, Yelena Slinin, Kamakshi Lakshminarayan, Cynthia S Davey, Anne Murray
BACKGROUND: Chronic kidney disease (CKD) studies have reported variable prevalence of brain pathologies, in part due to low inclusion of participants with moderate to severe CKD. OBJECTIVE: To measure the association between kidney function biomarkers and brain MRI findings in CKD. METHODS: In the BRINK (BRain IN Kidney Disease) study, MRI was used to measure gray matter volumes, cerebrovascular pathologies (white matter hyperintensity (WMH), infarctions, microhemorrhages), and microstructural changes using diffusion tensor imaging (DTI)...
October 19, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27754167/sy-12-3-are-ras-inhibitors-necessary-for-all-patients-with-diabetes-and-chronic-kidney-disease
#8
Shokei Kim-Mitsuyama
There is accumulating evidence that RAS inhibitors not only reduce blood pressure, but also exert pleiotropic effects, including a renoprotective effect, amelioration of insulin resistance, reduction in onset of diabetes, and suppression of cardiovascular remodelling,. However, the definite benefit of RAS inhibition in treatment of hypertension with CKD or DM is not conclusive. We previously performed the OlmeSartan and Calcium Antagonists Randomized (OSCAR) study comparing the preventive effect of high-dose ARB therapy versus ARB plus CCB combination therapy on cardiovascular morbidity and mortality in 1164 Japanese elderly hypertensive patients with baseline type 2 diabetes and/or CVD (Am J Med (2012))...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27747026/emerging-co-morbidities-of-obstructive-sleep-apnea-cognition-kidney-disease-and-cancer
#9
Nadia Gildeh, Panagis Drakatos, Sean Higgins, Ivana Rosenzweig, Brian D Kent
Obstructive sleep apnea (OSA) causes daytime fatigue and sleepiness, and has an established relationship with cardiovascular and metabolic disease. Recent years have seen the emergence of an evidence base linking OSA with an increased risk of degenerative neurological disease and associated cognitive impairment, an accelerated rate of decline in kidney function with an increased risk of clinically significant chronic kidney disease (CKD), and with a significantly higher rate of cancer incidence and death. This review evaluates the evidence base linking OSA with these seemingly unrelated co-morbidities, and explores potential mechanistic links underpinning their development in patients with OSA, including intermittent hypoxia (IH), sleep fragmentation, sympathetic excitation, and immune dysregulation...
September 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27704252/extrarenal-effects-of-fgf23
#10
Dieter Haffner, Maren Leifheit-Nestler
Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular mortality, infections, and impaired cognitive function. It is characterized by excessively increased levels of the phosphaturic hormone fibroblast growth factor 23 (FGF23) and a deficiency of its co-receptor Klotho. Despite the important physiological effect of FGF23 in maintaining phosphate homeostasis, there is increasing evidence that higher FGF23 levels are a risk factor for mortality and cardiovascular disease. FGF23 directly induces left ventricular hypertrophy via activation of the FGF receptor 4/calcineurin/nuclear factor of activated T cells signaling pathway...
October 4, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27688858/is-it-possible-to-delay-or-prevent-age-related-cognitive-decline
#11
REVIEW
Jean-Pierre Michel
Already in the 90s, Khachaturian stated that postponing dementia onset by five years would decrease the prevalence of the late onset dementia by 50%. After two decades of lack of success in dementia drug discovery and development, and knowing that worldwide, currently 36 million patients have been diagnosed with Alzheimer's disease, a number that will double by 2030 and triple by 2050, the World Health Organization and the Alzheimer's Disease International declared that prevention of cognitive decline was a 'public health priority...
September 2016: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/27680506/influence-of-cerebral-white-matter-hyperintensities-on-cognitive-impairment-in-elderly-medical-patients
#12
Koichi Shibata, Yoshiko Nishimura, Kuniaki Otsuka, Hiroshi Sakura
AIM: We investigated the characteristics of elderly medical patients with white matter hyperintensities on magnetic resonance imaging. METHODS: A total of 213 patients (123 men and 90 women; mean age 74.8 years) reported their history of hypertension, diabetes, dyslipidemia, previous stroke, coronary heart disease and chronic kidney disease (CKD). All patients completed the Mini-Mental State Examination and Geriatric Depression Scale. White matter hyperintensities were evaluated for the periventricular region, basal ganglia (BGH), deep white matter and infratentorial region, and brain atrophy was calculated as bicaudate ratios...
September 29, 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/27643122/sy-12-3-are-ras-inhibitors-necessary-for-all-patients-with-diabetes-and-chronic-kidney-disease
#13
Shokei Kim-Mitsuyama
There is accumulating evidence that RAS inhibitors not only reduce blood pressure, but also exert pleiotropic effects, including a renoprotective effect, amelioration of insulin resistance, reduction in onset of diabetes, and suppression of cardiovascular remodelling,. However, the definite benefit of RAS inhibition in treatment of hypertension with CKD or DM is not conclusive. We previously performed the OlmeSartan and Calcium Antagonists Randomized (OSCAR) study comparing the preventive effect of high-dose ARB therapy versus ARB plus CCB combination therapy on cardiovascular morbidity and mortality in 1164 Japanese elderly hypertensive patients with baseline type 2 diabetes and/or CVD (Am J Med (2012))...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27604306/retinal-vasculopathy-with-cerebral-leukoencephalopathy-and-systemic-manifestations
#14
Anine H Stam, Parul H Kothari, Aisha Shaikh, Andreas Gschwendter, Joanna C Jen, Suzanne Hodgkinson, Todd A Hardy, Michael Hayes, Peter A Kempster, Katya E Kotschet, Ingeborg M Bajema, Sjoerd G van Duinen, Marion L C Maat-Schieman, Paulus T V M de Jong, Marc D de Smet, Didi de Wolff-Rouendaal, Greet Dijkman, Nadine Pelzer, Grant R Kolar, Robert E Schmidt, JoAnne Lacey, Daniel Joseph, David R Fintak, M Gilbert Grand, Elizabeth M Brunt, Helen Liapis, Rula A Hajj-Ali, Mark C Kruit, Mark A van Buchem, Martin Dichgans, Rune R Frants, Arn M J M van den Maagdenberg, Joost Haan, Robert W Baloh, John P Atkinson, Gisela M Terwindt, Michel D Ferrari
Cerebroretinal vasculopathy, hereditary vascular retinopathy, and hereditary endotheliopathy, retinopathy, nephropathy and stroke are neurovascular syndromes initially described as distinct entities. Recently they were shown to be one disease caused by C-terminal frame-shift mutations in TREX1, which was termed 'retinal vasculopathy with cerebral leukodystrophy'. Here we defined the genetic and clinicopathologic spectrum of this clinically and pathophysiologically poorly characterized and frequently misdiagnosed fatal neurovascular disorder...
September 6, 2016: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/27598362/utility-of-the-montreal-cognitive-assessment-as-a-screening-test-for-neurocognitive-dysfunction-in-adults-with-sickle-cell-disease
#15
Cody Cichowitz, Patrick C Carroll, John J Strouse, Carlton Haywood, Sophie Lanzkron
OBJECTIVES: Neurocognitive dysfunction is an important complication of sickle cell disease (SCD), but little is published on the utility of screening tests for cognitive impairment in people with the disease. The purpose of this study was to evaluate the Montreal Cognitive Assessment (MoCA) as a screening tool and identify predictors of MoCA performance in adults with sickle cell disease. METHODS: We conducted a retrospective, cross-sectional study of the first 100 adult patients with SCD who completed the MoCA as part of routine clinical care at the Johns Hopkins Sickle Cell Center for Adults...
September 2016: Southern Medical Journal
https://www.readbyqxmd.com/read/27565993/-diagnostic-approach-to-iron-deficiency-anemia
#16
Kristine Jimenez, Michaela Lang
Anemia affects a fourth of the global population, with iron deficiency remaining the primary cause. It is associated with diminished work capacity, fatigue, impaired cognitive function, and can negatively impact the course of diseases like chronic heart failure or chronic kidney disease. Treatment options include oral and intravenous iron; however, conditions such as inflammatory bowel disease, celiac disease, or autoimmune gastritis can diminish the efficacy of oral iron. Timely recognition of iron deficiency anemia and administration of appropriate therapy not only improves quality of life, but also reduces the need for blood transfusions...
October 2016: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27519274/standardised-outcomes-in-nephrology-children-and-adolescents-song-kids-a-protocol-for-establishing-a-core-outcome-set-for-children-with-chronic-kidney-disease
#17
Allison Tong, Susan Samuel, Michael Zappitelli, Allison Dart, Susan Furth, Allison Eddy, Jaap Groothoff, Nicholas J A Webb, Hui-Kim Yap, Detlef Bockenhauer, Aditi Sinha, Stephen I Alexander, Stuart L Goldstein, Debbie S Gipson, Camilla S Hanson, Nicole Evangelidis, Sally Crowe, Tess Harris, Brenda R Hemmelgarn, Braden Manns, John Gill, Peter Tugwell, Wim Van Biesen, David C Wheeler, Wolfgang C Winkelmayer, Jonathan C Craig
BACKGROUND: Children with chronic kidney disease (CKD), requiring dialysis or kidney transplantation, have a mortality rate of up to 30-fold higher than the general aged-matched population, and severely impaired quality of life. Symptoms such as fatigue and pain are prevalent and debilitating. Children with CKD are at risk of cognitive impairment, and poorer educational, vocational, and psychosocial outcomes compared with their well peers, which have consequences through to adulthood...
2016: Trials
https://www.readbyqxmd.com/read/27505310/a-comparison-of-the-extent-and-pattern-of-cognitive-impairment-among-predialysis-dialysis-and-transplant-patients-a-cross-sectional-study-from-australia
#18
Judy Mullan, Kylie Mansfield, Maureen Lonergan
AIM: The aim of this study was to compare the extent of cogntive impairment and the types of cognitive deficits in an Australian cohort of four patient groups with end stage kidney disease. Characteristics predicting the presence of cognitive impairment were also evaluated. METHODS: Observational cross sectional study of one hundred and fifty five patients with end stage kidney disease recruited from a regional Australian renal unit. Eligible participants included those whose estimated Glomerular Filtration Rate was < 30 ml/min/1...
August 9, 2016: Nephrology
https://www.readbyqxmd.com/read/27475661/consequences-of-ckd-on-functioning
#19
REVIEW
Piyawan Kittiskulnam, Anoop Sheshadri, Kirsten L Johansen
Chronic kidney disease (CKD) is highly prevalent in the United States and throughout the world,(1) with approximately 13% of adults affected.(2) In addition, according to recent estimates, almost half of patients with CKD stages 3 to 5 are 70 years of age and older.(2) In the United States, the number of prevalent end-stage renal disease cases continues to increase in patients older than age 65. In light of the demographic characteristics of patients with CKD and ESRD, there has been considerable focus on associations between CKD and cardiovascular outcomes...
July 2016: Seminars in Nephrology
https://www.readbyqxmd.com/read/27447457/-strategies-of-age-adapted-pharmacotherapy-in-renal-failure
#20
R Lenssen, A Liekweg
Many geriatric patients with multimorbidities have an increased risk for impaired renal function due to age and often the presence of comorbidities, such as diabetes mellitus, hypertension and heart failure. This impairment in kidney function in turn necessitates adjustments in drug therapy. A successful strategy for treating these patients includes treatment of the underlying diseases, a comprehensive review of the indications, selection of appropriate pharmacotherapeutic alternatives and for some drugs dose adjustment to the renal function...
August 2016: Zeitschrift Für Gerontologie und Geriatrie
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