Kelly Dearbhla M, Rothwell Peter M
J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
Wolfson Center for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom.
Front Neurol. 2022 Feb 25;13:830064. doi: 10.3389/fneur.2022.830064. eCollection 2022.
Chronic kidney disease (CKD) is a rapidly rising global health burden that affects nearly 40% of older adults. Epidemiologic data suggest that individuals at all stages of chronic kidney disease (CKD) have a higher risk of developing cognitive disorders and dementia, and thus represent a vulnerable population. It is currently unknown to what extent this risk may be attributable to a clustering of traditional risk factors such as hypertension and diabetes mellitus leading to a high prevalence of both symptomatic and subclinical ischaemic cerebrovascular lesions, or whether other potential mechanisms, including direct neuronal injury by uraemic toxins or dialysis-specific factors could also be involved. These knowledge gaps may lead to suboptimal prevention and treatment strategies being implemented in this group. In this review, we explore the mechanisms of susceptibility and risk in the relationship between CKD and cognitive disorders.
慢性肾脏病(CKD)是一个迅速加重的全球健康负担,影响着近40%的老年人。流行病学数据表明,处于慢性肾脏病(CKD)各阶段的个体发生认知障碍和痴呆的风险更高,因此是一个脆弱人群。目前尚不清楚这种风险在多大程度上可归因于高血压和糖尿病等传统风险因素的聚集,从而导致有症状和亚临床缺血性脑血管病变的高患病率,或者其他潜在机制,包括尿毒症毒素或透析特异性因素导致的直接神经元损伤是否也起作用。这些知识空白可能导致针对该群体的预防和治疗策略欠佳。在本综述中,我们探讨了慢性肾脏病与认知障碍之间关系中的易感性和风险机制。