期刊
JOURNAL OF NEURAL TRANSMISSION
卷 121, 期 6, 页码 627-632出版社
SPRINGER WIEN
DOI: 10.1007/s00702-014-1160-z
关键词
Cerebral microangiopathy; Cerebral small vessel disease; Hemodialysis; Hemodynamics; Inflammation; Ischemic brain infarct
资金
- Federal Ministry of Education and Research [BMBF/NGFN 01GR0807]
- Heinz Nixdorf Foundation
- Dr. Werner Jackstadt Foundation
Cognitive deficits have a high prevalence in elderly patients with chronic kidney disease (CKD). The clinical picture consists of cognitive slowing, executive, memory and language deficits, and is attributed to cerebral white matter disease and clinically often silent brain infarcts. In the meantime, robust evidence exists that low estimated glomerular filtration rate, a measure of CKD severity, predisposes to cognitive deficits, cerebral white matter lesions, and ischemic brain infarcts in addition to demographic factors, vascular risk factors and diseases which also contribute to CKD-related cognitive deficits. In terminal CKD, cerebral blood flow is compromized during hemodialysis sessions, resulting in oxygen desaturation, cognitive deterioration and-in the longer run-brain atrophy. Kidney transplantation improves cognitive deficits in terminal CKD. At all stages, vascular risk factors and associated diseases should stringently be treated according to therapeutic guidelines.
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