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cognitive impairment and CKD

Kristen L Nowak, Michel Chonchol
Chronic, low-grade inflammation is a common comorbid condition in chronic kidney disease (CKD), and particularly in chronic dialysis patients. In this review, we consider the question of whether inflammation affects outcomes in dialysis patients. Levels of proinflammatory cytokines, as well as C-reactive protein, are elevated in chronic dialysis patients. Multiple factors likely contribute to chronic inflammatory activation in kidney disease patients including the uremic milieu, lifestyle and epigenetic influences, infectious and thrombotic events, the dialysis process, and dysbiosis...
March 7, 2018: Seminars in Dialysis
Kerry Chen, Madeleine Didsbury, Anita van Zwieten, Martin Howell, Siah Kim, Allison Tong, Kirsten Howard, Natasha Nassar, Belinda Barton, Suncica Lah, Jennifer Lorenzo, Giovanni Strippoli, Suetonia Palmer, Armando Teixeira-Pinto, Fiona Mackie, Steven McTaggart, Amanda Walker, Tonya Kara, Jonathan C Craig, Germaine Wong
BACKGROUND AND OBJECTIVES: Poor cognition can affect educational attainment, but the extent of neurocognitive impairment in children with CKD is not well understood. This systematic review assessed global and domain-specific cognition and academic skills in children with CKD and whether these outcomes varied with CKD stage. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Electronic databases were searched for observational studies of children with CKD ages 21 years old or younger that assessed neurocognitive or educational outcomes...
February 22, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Muhammed Khairujjaman Mazumder, Banashree Chetia Phukan, Aradhana Bhattacharjee, Anupom Borah
Chronic kidney disease (CKD) is an increasing global health burden. Disturbance in purine metabolism pathway and a higher level of serum uric acid, called hyperuricemia, is a risk factor of CKD, and it has been linked to increased prevalence and progression of the disease. In a recent study, it has been demonstrated that purine nucleotides and uric acid alter the activity of acetylcholinesterase (AChE). Thus, we hypothesize that adenine, hypoxanthine, xanthine, 2,8-dihydroxyadenine and uric acid may potentially interfere with the activity of AChE...
February 2018: Medical Hypotheses
Erum A Hartung, Guray Erus, Abbas F Jawad, Nina Laney, Jimit J Doshi, Stephen R Hooper, Jerilynn Radcliffe, Christos Davatzikos, Susan L Furth
BACKGROUND: The neuroanatomic basis for cognitive impairment in chronic kidney disease (CKD) is incompletely characterized. We performed advanced quantitative structural magnetic resonance imaging (MRI) to determine whether CKD affects brain structure and whether poorer neurocognitive performance in CKD is associated with structural brain differences. STUDY DESIGN: Cross-sectional. SETTING & PARTICIPANTS: 85 individuals with CKD stages 2 to 5 and 63 healthy controls, aged 8 to 25 years PREDICTORS: CKD versus control, estimated glomerular filtration rate (eGFR), and kidney transplant status were analyzed as predictors of MRI findings...
February 1, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Pushpendra N Renjen, Dinesh Chaudhari, Gaurav Sagar, Sanjiv Jasuja
Chronic kidney disease (CKD) is a critical and rapidly growing global health problem. Neurological complications occur in almost all patients with severe CKD, potentially affecting all levels of the nervous system, from the central nervous system (CNS) through to the peripheral nervous system (PNS). Patients with CKD exhibit a high incidence of symptomatic and occult cerebrovascular diseases, associated tremendously high levels of inflammatory factors and homocysteine, as well as anemia, hypertension, and diabetes...
January 2018: Neurology India
Christine M Burns, David S Knopman, David E Tupper, Cynthia S Davey, Yelena M Slinin, Kamakshi Lakshminarayan, Rebecca C Rossom, Sarah L Pederson, David T Gilbertson, Anne M Murray
Background: Our primary goal is to describe the prevalence, severity, and risk of cognitive impairment (CI) by estimated glomerular filtration rate (eGFR, in ml/min/1.73 m 2) in a cohort enriched for advanced CKD (eGFR < 45), adjusting for albuminuria, as measured by urine albumin-to-creatinine ratio (UACR, in mg/g). As both eGFR and albuminuria are associated with CI risk in CKD, we also seek to determine the extent that eGFR remains a useful biomarker for risk of CI in those with CKD and concomitant albuminuria...
December 13, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Vladimir Prelevic, Danilo Radunovic, Tanja Antunovic, Marina Ratkovic, Najdana Gligorovic-Bahranovic, Branka Gledovic, Snezana Vujosevic, Mirjana Nedovic-Vukovic, Nikolina Basic-Jukic
Prevalence of cognitive function decline in end stage renal disease (ESRD) patients undergoing hemodialysis is higher than in the general population. We analyzed risk factors for cognitive function decline in those patients. This study included 93 ESRD patients undergoing hemodialysis two or three times a week in three centers for hemodialysis in Montenegro. The cognitive status of patients was assessed using the mini mental score examination (MMSE) test. All 93 patients have been divided into three groups according to the results of MMSE...
December 7, 2017: Therapeutic Apheresis and Dialysis
Maximilian König, Maik Gollasch, Dominik Spira, Nikolaus Buchmann, Werner Hopfenmüller, Elisabeth Steinhagen-Thiessen, Ilja Demuth
BACKGROUND: Mild-to-moderate chronic kidney disease (CKD G3a) is prevalent in older adults. Substantial evidence suggests that individuals with advanced CKD face a high risk for common geriatric conditions, like functional impairment and cognitive decline, whereas the relationships between mild-to-moderate CKD and functional impairment and cognitive decline, but also poor nutritional status and mood disorders, are still unclear. OBJECTIVE: The aim of this study was to explore associations between mild-to-moderate CKD and impairments in the core domains of geriatric assessment (GA) in a large cohort of community-dwelling older adults...
2018: Gerontology
E E Reza-Zaldívar, S Sandoval-Avila, Y K Gutiérrez-Mercado, E Vázquez-Méndez, A A Canales-Aguirre, H Esquivel-Solís, U Gómez-Pinedo, A L Márquez-Aguirre
INTRODUCTION: Chronic kidney disease (CKD) can cause anaemia and neurological disorders. Recombinant human erythropoietin (rHuEPO) is used to manage anaemia in CKD. However, there is little evidence on the effects of rHuEPO on behaviour and cognitive function in CKD. This study aimed to evaluate the impact of rHuEPO in sensorimotor and cognitive functions in a CKD model. METHODS: Male Wistar rats were randomly assigned to 4 groups: control and CKD, with and without rHuEPO treatment (1050 IU per kg body weight, once weekly for 4 weeks)...
November 10, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Euan N Paterson, Michael A Williams, Peter Passmore, Giuliana Silvestri, Tom J MacGillivray, Alexander P Maxwell, Gareth J McKay
BACKGROUND: Alzheimer's disease (AD) prevalence is increasing globally and typically progresses for several years prior to clinical presentation of dementia. Renal dysfunction and vascular disease have been reported in association with dementia in several cross-sectional and longitudinal studies, and may contribute to AD risk. Experimental and observational studies suggest amyloid-β (Aβ) clearance may be impaired in chronic kidney disease (CKD) indicating a mechanism for increased AD risk...
October 11, 2017: Journal of Alzheimer's Disease: JAD
Yuhei Otobe, Koji Hiraki, Chiharu Hotta, Hajime Nishizawa, Kazuhiro P Izawa, Yasuhiro Taki, Naohiko Imai, Tsutomu Sakurada, Yugo Shibagaki
AIM: Chronic kidney disease (CKD) is a risk factor for declining cognitive and physical function. However, the prevalence of mild cognitive impairment (MCI) and its relationship with physical function is not clear. Therefore, our aim was to evaluate the prevalence of MCI and the relationship between MCI and physical function among older adults with pre-dialysis CKD. METHODS: We conducted a cross-sectional study of 120 patients, aged ≥ 65 years (mean age, 77.3 years), with pre-dialysis CKD but without probable dementia (Mini Mental State Examination < 24)...
September 26, 2017: Nephrology
Jing Wu, Yu-Mei Zhao, Zhi-Kuan Deng
Chronic kidney disease (CKD) is a significant global health concern with limited treatment options. Oxidative stress and inflammatory responses have been implicated in the pathology of CKD. Patients with CKD are frequently affected with neurological complications that affect both the central and peripheral nervous system. Identification of effective treatment strategies are of much clinical value in the therapy of CKD. Tangeretin, a plant-derived flavonoid has been described to retain extensive pharmacological properties...
September 4, 2017: Inflammopharmacology
Bahman Jabbari, Nosratola D Vaziri
Perhaps no other organ in the body is affected as often and in as many ways as the brain is in patients with chronic kidney disease (CKD). Several factors contribute to the neurological disorders in CKD including accumulation of uremic toxins, metabolic and hemodynamic disorders, oxidative stress, inflammation, and impaired blood brain barrier among others. The neurological disorders in CKD involve both peripheral and central nervous system. The peripheral neurological symptoms of CKD are due to somatic and cranial peripheral neuropathies as well as a myopathy...
August 11, 2017: Hemodialysis International
Andrea Knight, Amy J Kogon, Matthew B Matheson, Bradley A Warady, Susan L Furth, Stephen R Hooper
OBJECTIVE: To identify factors contributing to cognitive impairment in children with lupus nephritis. STUDY DESIGN: A cross-sectional analysis of a large multicenter national cohort of children with chronic kidney disease (CKD) using standardized measures to determine baseline neuropsychiatric function and health-related quality of life (HRQoL) in children with lupus nephritis (n = 34), and to compare baseline function with that in children with other forms of glomerular CKD (gCKD; n = 171)...
October 2017: Journal of Pediatrics
Timmy Lee
The vascular access is the lifeline for the hemodialysis patient. In the United States, the Fistula First Breakthrough Initiative (FFBI) has been influential in improving use of arteriovenous fistulas (AVF) in prevalent hemodialysis patients. Currently, prevalent AVF rates are near the goal of 66% set forth by the original FFBI. However, central venous catheter (CVC) rates remain very high in the United States in patients initiating hemodialysis, nearly exceeding 80%. A new direction of the of the FFBI has focused on strategies to reduce CVC use, and subsequently the FFBI has now been renamed the "Fistula First-Catheter Last Initiative"...
September 2017: Cardiovascular Engineering and Technology
Eve Miller-Hodges, Neeraj Dhaun
Chronic kidney disease (CKD) is common, its prevalence increasing with age. Cognitive impairment is common in the elderly, in CKD and in those on maintenance haemodialysis. As cognitive impairment is the precursor to dementia, the identification of reversible risk factors for cognitive decline is the key to reducing dementia risk. Arterial stiffness is one such potential risk factor. It is independently associated with cardiovascular outcome in dialysis patients. Importantly, the recent demonstration of an independent association between arterial stiffness and cognitive impairment in these patients suggests that vascular stiffness might be potentially causative in the development of cognitive impairment and also be an opportune target for interventions...
July 1, 2017: Clinical Science (1979-)
Osasuyi Iyasere, David Okai, Edwina Brown
Background: Cognitive impairment commonly affects renal patients. But little is known about the influence of dialysis modality on cognitive trends or the influence of cognitive impairment on decision-making in renal patients. This study evaluated cognitive trends amongst chronic kidney disease (CKD), haemodialysis (HD) and peritoneal dialysis (PD) patients. The relationship between cognitive impairment and decision-making capacity (DMC) was also assessed. Methods: Patients were recruited from three outpatient clinics...
February 2017: Clinical Kidney Journal
Doaa Mohammed Youssef, Ahmed Hosny Mohamed, Wafaa Mahmoud Kamel Attia, Faten Fawzy Mohammad, Nelly Rafaat Abd El Fatah, Amal Saeed Elshal
BACKGROUND: Many studies described Impaired intelligence, attention, memory and executive function in patients with chronic kidney disease (CKD) dialyzed and non-dialyzed, but there is still lacking the early and sensitive method of detection of these deficits. The purpose of this study is to investigate relation between the brain metabolic alteration [measured by magnetic resonance spectroscopy (MRS)] and cognitive dysfunction in CKD children (detected by psychometric analysis). SUBJECTS AND METHODS: One hundred and forty patients with CKD were included [ 40 patients with stage 5 CKD on dialysis, 30 patients with stage 4 to 5 CKD without dialysis, and 70 patients with stage 1 to 3 CKD]...
June 16, 2017: Nephrology
Aline Silva Miranda, Thiago Macedo Cordeiro, Thomas Mucida Dos Santos Lacerda Soares, Rodrigo Novaes Ferreira, Ana Cristina Simões E Silva
Epidemiologic data suggest that individuals at all stages of chronic kidney disease (CKD) have a higher risk of developing neuropsychiatric disorders, cognitive impairment, and dementia. This risk is generally explained by the high prevalence of both symptomatic and subclinical ischemic cerebrovascular lesions. However, other potential mechanisms, including cytokine/chemokine release, production of reactive oxygen species (ROS), circulating and local formation of trophic factors and of renin-angiotensin system (RAS) molecules, could also be involved, especially in the absence of obvious cerebrovascular disease...
June 1, 2017: Clinical Science (1979-)
Ulf G Bronas, Houry Puzantian, Mary Hannan
Chronic kidney disease (CKD) is considered a model of accelerated aging. More specifically, CKD leads to reduced physical functioning and increased frailty, increased vascular dysfunction, vascular calcification and arterial stiffness, high levels of systemic inflammation, and oxidative stress, as well as increased cognitive impairment. Increasing evidence suggests that the cognitive impairment associated with CKD may be related to cerebral small vessel disease and overall impairment in white matter integrity...
2017: BioMed Research International
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