Drugs with a negative impact on cognitive functions (part 3): antibacterial agents in patients with chronic kidney disease.

Autor: Liabeuf S; Pharmacoepidemiology Unit, Department of Clinical Pharmacology, Amiens University Medical Center, Amiens, France.; MP3CV Laboratory, EA7517, Jules Verne University of Picardie, Amiens, France., Hafez G; Department of Pharmacology, Faculty of Pharmacy, Altinbas University, Istanbul, Turkey., Pešić V; Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia., Spasovski G; Department of Nephrology, Clinical Centre 'Mother Theresa', Saints Cyril and Methodius University, Skopje, North Macedonia., Bobot M; Aix-Marseille University, Department of Nephrology, AP-HM, La Conception Hospital, Marseille, France; C2VN Laboratory, Inserm 1263, INRAE 1260, Aix-Marseille University, Marseille, France., Mačiulaitis R; Department of Nephrology, Lithuanian University of Health Sciences, Kaunas, Lithuania.; Institute of Physiology and Pharmacology, Faculty of Medicines, Lithuanian University of Health Sciences, Kaunas, Lithuania., Bumblyte IA; Department of Nephrology, Lithuanian University of Health Sciences, Kaunas, Lithuania., Ferreira AC; Nephrology Department, Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal.; Universidade Nova de Lisboa-Faculdade de Ciências Médicas-Nephology, Lisbon, Portugal., Farinha A; Department of Nephrology, Hospital de Vila Franca de Xira, Lisbon, Portugal., Malyszko J; Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, Warsaw, Poland., Pépin M; Department of Geriatrics, Ambroise Paré University Medical Center, APHP, Boulogne-Billancourt, France.; Paris-Saclay University, UVSQ, Inserm, Clinical Epidemiology Team, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Villejuif, France., Massy ZA; Paris-Saclay University, UVSQ, Inserm, Clinical Epidemiology Team, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Villejuif, France.; Department of Nephrology, Ambroise Paré University Medical Center, APHP, Paris, France., Unwin R; Department of Renal Medicine, Royal Free Hospital, University College London, London, UK., Capasso G; Department of Translantional Medical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy.; Biogem Research Institute, Ariano Irpino, Italy., Mani LY; Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Jazyk: angličtina
Zdroj: Clinical kidney journal [Clin Kidney J] 2024 Jun 14; Vol. 17 (8), pp. sfae174. Date of Electronic Publication: 2024 Jun 14 (Print Publication: 2024).
DOI: 10.1093/ckj/sfae174
Abstrakt: The relationship between chronic kidney disease (CKD) and cognitive function has received increased attention in recent years. Antibacterial agents (ABs) represent a critical component of therapy regimens in patients with CKD due to increased susceptibility to infections. Following our reviewing work on the neurocognitive impact of long-term medications in patients with CKD, we propose to focus on AB-induced direct and indirect consequences on cognitive function. Patients with CKD are predisposed to adverse drug reactions (ADRs) due to altered drug pharmacokinetics, glomerular filtration decline, and the potential disruption of the blood-brain barrier. ABs have been identified as a major cause of ADRs in vulnerable patient populations. This review examines the direct neurotoxic effects of AB classes (e.g. beta-lactams, fluoroquinolones, aminoglycosides, and metronidazole) on the central nervous system (CNS) in patients with CKD. We will mainly focus on the acute effects on the CNS associated with AB since they are the most extensively studied effects in CKD patients. Moreover, the review describes the modulation of the gut microbiota by ABs, potentially influencing CNS symptoms. The intricate brain-gut-kidney axis emerges as a pivotal focus, revealing the interplay between microbiota alterations induced by ABs and CNS manifestations in patients with CKD. The prevalence of antibiotic-associated encephalopathy in patients with CKD undergoing intravenous AB therapy supports the use of therapeutic drug monitoring for ABs to reduce the number and seriousness of ADRs in this patient population. In conclusion, elucidating AB-induced cognitive effects in patients with CKD demands a comprehensive understanding and tailored therapeutic strategies that account for altered pharmacokinetics and the brain-gut-kidney axis.
Competing Interests: Robert Unwin is currently working as a Chief Scientist (Kidney Diseases) in Translational Science and Experimental Medicine, Early CVRM (Cardiovascular, Renal and Metabolism), BioPharmaceutical R&D, AstraZeneca, Cambridge, UK. Other authors declare no conflicts of interest related to this work.
(© The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.)
Databáze: MEDLINE
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