Neurology Division, Internal Medicine Department, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Madero y Gonzalitos S/N, 64700, Monterrey, NL, Mexico.
Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico.
Metab Brain Dis. 2021 Jan;36(1):1-12. doi: 10.1007/s11011-020-00623-1. Epub 2020 Sep 29.
Chronic kidney disease (CKD) has been typically implicated in cardiovascular risk, considering the function the kidney has related to blood pressure, vitamin D, red blood cell metabolism, and electrolyte and acid-base regulation. However, neurological consequences are also attributed to this disease. Among these, recent large epidemiological studies have demonstrated an increased risk for Parkinson's disease (PD) in patients with CKD. Multiple studies have evaluated individually the association of blood pressure, vitamin D, and red blood cell dysmetabolism with PD, however, no study has reviewed the potential mechanisms related to these components in context of CKD and PD. In this review, we explored the association of CKD and PD and linked the components of the former to propose potential pathways explaining a future increased risk for PD, where renin-angiotensin system, oxidative stress, and inflammation have a main role. Potential preventive and therapeutic interventions based on these associations are also explored. More preclinical studies are needed to confirm the potential link of CKD conditions and future PD risk, whereas more interventional studies targeting this association are warranted to confirm their potential benefit in PD.
慢性肾脏病(CKD)通常与心血管风险有关,因为肾脏的功能与血压、维生素 D、红细胞代谢以及电解质和酸碱平衡的调节有关。然而,该疾病也会导致神经系统的后果。其中,最近的大型流行病学研究表明,CKD 患者患帕金森病(PD)的风险增加。多项研究分别评估了血压、维生素 D 和红细胞代谢异常与 PD 的关系,但没有研究综述这些成分与 CKD 和 PD 相关的潜在机制。在这篇综述中,我们探讨了 CKD 和 PD 之间的关联,并将前者的成分联系起来,提出了可能导致未来 PD 风险增加的潜在途径,其中肾素-血管紧张素系统、氧化应激和炎症起着主要作用。还探讨了基于这些关联的潜在预防和治疗干预措施。需要更多的临床前研究来证实 CKD 与未来 PD 风险之间的潜在联系,而针对这种关联的更多干预性研究也需要证实它们在 PD 中的潜在益处。