Cognitive disorders in patients with chronic kidney disease: Approaches to prevention and treatment

European Journal of Neurology, Journal Year: 2023, Volume and Issue: 30(9), P. 2899 - 2911

Published: June 16, 2023

Cognitive impairment is common in patients with chronic kidney disease (CKD), and early intervention may prevent the progression of this condition.Here, we review interventions for complications CKD (anemia, secondary hyperparathyroidism, metabolic acidosis, harmful effects dialysis, accumulation uremic toxins) prevention vascular events, that potentially be protective against cognitive impairment. Furthermore, discuss nonpharmacological pharmacological methods to and/or minimize latter's impact on patients' daily lives.A particular attention function assessment suggested during work-up Different approaches are promising reduce burden but availabe dedicated data scarce.There a need studies assessing effect CKD.

Language: Английский

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Physiological relevance of proton-activated GPCRs

Pflügers Archiv - European Journal of Physiology, Journal Year: 2022, Volume and Issue: 474(5), P. 487 - 504

Published: March 5, 2022

Abstract The detection of H + concentration variations in the extracellular milieu is accomplished by a series specialized and non-specialized pH-sensing mechanisms. proton-activated G protein–coupled receptors (GPCRs) GPR4 (Gpr4), TDAG8 (Gpr65), OGR1 (Gpr68) form subfamily proteins capable triggering intracellular signaling response to alterations pH around physiological values, i.e., range between 7.5 6.5. Expression these widespread for with particularly high levels endothelial cells vascular smooth muscle cells, respectively, while expression appears be more restricted immune compartment. These have been linked several well-studied pH-dependent activities including central control respiration, renal adaption changes acid–base status, secretion insulin peripheral responsiveness insulin, mechanosensation, cellular chemotaxis. Their role pathological processes such as genesis progression inflammatory diseases (asthma, bowel disease), tumor cell metabolism invasiveness, increasingly receiving attention makes novel interesting targets therapy. In this review, we cover will briefly discuss some implications disease processes.

Language: Английский

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Role of proton-activated G protein-coupled receptors in pathophysiology

AJP Cell Physiology, Journal Year: 2022, Volume and Issue: 323(2), P. C400 - C414

Published: June 27, 2022

Local acidification is a common feature of many disease processes such as inflammation, infarction, or solid tumor growth. Acidic pH not merely sequela but contributes to recruitment and regulation immune cells, modifies metabolism parenchymal, modulates fibrosis, vascular permeability, oxygen availability, consumption, invasiveness impacts on cell survival. Thus, multiple pH-sensing mechanisms must exist in cells involved these processes. These sensors play important roles normal physiology pathophysiology, hence might be attractive targets for pharmacological interventions. Among the mechanisms, OGR1 ( GPR68), GPR4 GPR4), TDAG8 GPR65) have emerged molecules. G protein-coupled receptors are widely expressed, upregulated inflammation tumors, sense changes extracellular range between 8 6, modulating key biology, fibrosis. This review discusses features highlights states pathways affected by their activity.

Language: Английский

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Metabolic acidosis in chronic kidney disease: mere consequence or also culprit?

Pflügers Archiv - European Journal of Physiology, Journal Year: 2024, Volume and Issue: 476(4), P. 579 - 592

Published: Jan. 27, 2024

Abstract Metabolic acidosis is a frequent complication in non-transplant chronic kidney disease (CKD) and after transplantation. It occurs when net endogenous acid production exceeds excretion. While nephron loss with reduced ammoniagenesis the main cause of retention CKD patients, additional pathophysiological mechanisms are likely inflicted transplant recipients. Functional tubular damage by calcineurin inhibitors seems to play key role causing renal acidosis. Notably, experimental clinical studies over past decades have provided evidence that metabolic may not only be consequence but also driver disease. In acidosis, activation hormonal systems complement system resulting fibrosis been described. Further changes metabolism will contribute deeper understanding pathophysiology CKD. alkali supplementation case serum bicarbonate < 22 mmol/l has endorsed guidelines for many years slow functional decline, among other considerations, beneficial effects thresholds treatment lately under intense debate. This review article discusses this topic light most recent results trials assessing efficacy dietary pharmacological interventions patients.

Language: Английский

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Animal models to study cognitive impairment of chronic kidney disease

AJP Renal Physiology, Journal Year: 2024, Volume and Issue: 326(6), P. F894 - F916

Published: April 18, 2024

Mild cognitive impairment (MCI) is common in people with chronic kidney disease (CKD), and its prevalence increases progressive loss of function. MCI characterized by a decline performance greater than expected for an individual age education level but minimal instrumental activities daily living. Deterioration can affect one or several domains (attention, memory, executive functions, language, perceptual motor social cognition). Given the increasing disease, more CKD will also develop causing enormous burden these individuals, their relatives, society. However, underlying pathomechanisms are poorly understood, current therapies mostly aim at supporting patients lives. This illustrates urgent need to elucidate pathogenesis potential therapeutic targets test novel appropriate preclinical models. Here, we outline necessary criteria experimental modeling disorders CKD. We discuss use mice, rats, zebrafish as model systems present valuable techniques through which function be assessed this setting. Our objective enable researchers overcome hurdles accelerate research aimed improving therapy MCI.

Language: Английский

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Elevated serum creatinine levels and risk of cognitive impairment in older adults with diabetes: a NHANES study from 2011-2014

Frontiers in Endocrinology, Journal Year: 2023, Volume and Issue: 14

Published: Oct. 12, 2023

Background The brain and kidney have similar microvascular structure, which makes them susceptible to certain common pathophysiological processes. In this study, we examined several indicators of injury/function associated with cognitive function in older diabetic patients the hope finding effective markers for detecting impairment (CI). Methods A total 2209 participants (aged ≥60 years) from 2011-2014 National Health Nutrition Examination Survey (NHANES) were analyzed association between diabetes CI using a multiple linear regression analysis model. Using same approach, also relationship (Animal Fluency Test, Digit Symbol Substitution Test) population. Results Diabetes was CI. age-adjusted model, diabetics performed significantly poorer on tests compared normoglycaemic individuals (1.145 points lower Animal Test ( P = 0.005) 7.868 reduced &lt; 0.001)). diabetics, found elevated serum creatinine (SCr) (especially at SCr≥300uM) scores after strict adjustment potential influences function. While, albumin/creatinine ratio (ACR) only score (DSS) not (AFS), estimated glomerular filtration rate (eGFR) (AFS DSS) end-stage renal disease. Conclusion SCr, as sensitive indicator injury, can potentially be used an marker screening diabetics.

Language: Английский

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Neuroprotective Effects of Sodium Nitroprusside on CKD-Induced Cognitive Dysfunction in Rats: Role of CBS and Nrf2/HO-1 Pathway

NeuroMolecular Medicine, Journal Year: 2025, Volume and Issue: 27(1)

Published: Jan. 7, 2025

Language: Английский

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Associations of serum sodium, potassium and chloride levels with the all-cause and cardiovascular diseases mortality among patients with depression

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(2), P. e0314636 - e0314636

Published: Feb. 12, 2025

Background Electrolyte disturbances are relatively common in patients with depression, but they often overlooked, and the relationship between electrolyte changes adverse outcomes depression is not yet clear. This study aims to explore impact of serum levels on all-cause cardiovascular disease (CVD) mortality rates depression. Methods prospective cohort included 3127 who participated National Health Nutrition Examination Survey (NHANES) from 2005 through 2018. Depression was assessed using Patient Questionnaire (PHQ-9), a PHQ-9 score ≥10 defined as The data were analyzed April 1 July 30, 2024. Multivariable Cox proportional hazards regression model used calculate hazard ratios (HRs) 95% confidence intervals (CIs) sodium, potassium, chloride CVD risk Three multivariable models constructed. We further stratified analysis by age, gender, hypertension, smoking, alcohol consumption, diabetes, drinking status. Interaction significance estimated P-values for product terms chloride, stratification factors. Results 2946 participants (mean [SD] 50.13 [16.48] years; 1116 men [37.88]); During median (IQR) follow-up 7.2 (3.6–10.5) years, 398 deaths recorded, which 117 attributed CVD.After adjustment, compared first quartile sodium levels, HRs 0.90(95% CI, 0.53–1.53) fourth (p trend = 0.484). 0.73(95% 0.55–0.99) 0.003). A nonlinear association observed overall 0.003, p 0.047). Compared potassium 1.58(95% 0.98–2.54) 0.050), 1.52(95% 1.16–1.99) <0.001). overall<0.001, 0.005) 0.003) chlorine 0.84(95% 0.49–1.46) quartile(p 0.284). 0.70(95% 0.51–0.95) nonlinear<0.001) Conclusion correlations found that higher significantly correlated lower mortality, mortality.

Language: Английский

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CONNECT: what has been done and what needs to be done

Nephrology Dialysis Transplantation, Journal Year: 2025, Volume and Issue: 40(Supplement_2), P. ii1 - ii3

Published: March 1, 2025

Language: Английский

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Chemotherapy-related cognitive impairment and kidney dysfunction

Nephrology Dialysis Transplantation, Journal Year: 2025, Volume and Issue: 40(Supplement_2), P. ii54 - ii63

Published: March 1, 2025

ABSTRACT Cancer and kidney diseases (KD) intersect in many ways resulting worse outcomes. Both conditions are correlated with cognitive impairment, which can be exacerbated cancer patients by known effects of antineoplastic drugs on cognition, leading to a phenomenon as chemotherapy-related impairment (CRCI). This manifests poor attention span, disturbed short-term memory, general mental sluggishness. literature review explores CRCI investigates the potential impact KD this phenomenon. Additionally, we highlight shared pathogenetic mechanisms (including neurotoxicity, neuroinflammation, oxidative stress, vascular disease, electrolyte, acid-base imbalances), clinical presentation imaging findings between CRCI. The disruption blood–brain barrier might key mechanism for increased brain permeability anticancer nephropathic cancer. Based existing knowledge, found heightened neurotoxicity synergistic potentiation KD. However, further translational research is urgently required validate hypothesis.

Language: Английский

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