Brain Atrophy and Cognitive Impairment in Chronic Kidney Disease
| Autor: | Hisako Yoshida, Kazuhiko Tsuruya |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Oncology
education.field_of_study medicine.medical_specialty Anemia business.industry medicine.medical_treatment Population 030232 urology & nephrology urologic and male genital diseases medicine.disease Peritoneal dialysis 03 medical and health sciences 0302 clinical medicine Atrophy Internal medicine medicine Albuminuria Dementia medicine.symptom education business 030217 neurology & neurosurgery Executive dysfunction Kidney disease |
| Popis: | Background There is an increasing prevalence of dementia associated with population aging, and anti-dementia measures have now become of increasing importance in Japan. Chronic kidney disease (CKD) is a risk factor for cognitive impairment. Summary We previously demonstrated that hemodialysis patients have a higher prevalence of brain atrophy, even at younger age, than the general population, and also demonstrated the association between frontal lobe atrophy and frequency of rapid decline in blood pressure during the hemodialysis session. Recently, we demonstrated that decline in gray matter volume in CKD patients on peritoneal dialysis was significantly more rapid compared to non-dialysis-dependent CKD patients, and also showed a close association between gray matter atrophy and executive dysfunction in CKD patients, suggesting the importance of preventing brain atrophy for the prevention of cognitive impairment. Our recent epidemiological study demonstrated that both decreased kidney function and albuminuria were identified as independent risk factors for the development of dementia. In addition, it has been reported that possible contributing factors include anemia, oxidative stress, and the renin-angiotensin system (RAS). Previous reports have demonstrated that CKD patients with severe anemia show cognitive impairment, which was recovered by correction of anemia using erythropoiesis-stimulating agents. Then, we examined the role of oxidative stress and RAS using a mouse model of CKD-associated cognitive impairment, and demonstrated that the RAS inhibitor candesartan, as well as the antioxidant tempol, inhibited the development of cognitive impairment through inhibition of oxidative stress in the hippocampus. Key Messages: In CKD patients, progression of brain atrophy is more rapid and cognitive impairment is more common than in non-CKD subjects. Oxidative stress and RAS in the brain are associated with CKD-associated cognitive impairment. |
| Databáze: | OpenAIRE |
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