Iron Load Toxicity in Medicine: From Molecular and Cellular Aspects to Clinical Implications

International Journal of Molecular Sciences, Journal Year: 2023, Volume and Issue: 24(16), P. 12928 - 12928

Published: Aug. 18, 2023

Iron is essential for all organisms and cells. Diseases of iron imbalance affect billions patients, including those with overload other forms toxicity. Excess load an adverse prognostic factor diseases can cause serious organ damage fatalities following chronic red blood cell transfusions in patients many conditions, hemoglobinopathies, myelodyspasia, hematopoietic stem transplantation. Similar toxicity excess body but at a slower rate disease progression found idiopathic haemochromatosis patients. deposition different regions the brain suspected has been identified by MRI T2* similar methods neurodegenerative diseases, Alzheimer’s Parkinson’s disease. Based on its role as major biological catalyst free radical reactions Fenton reaction, also implicated associated pathology tissue damage. Furthermore, recent discovery ferroptosis, which death program based generation membrane lipid oxidation, sparked thousands investigations association cardiac, kidney, liver, cancer infections. The implications labile, non-protein bound form complexes dietary molecules such vitamin C drugs doxorubicin xenobiotic relation to carcinogenesis are discussed. In each case toxicity, mechanistic insights, diagnostic criteria, molecular interactions design new effective therapeutic interventions future targeted strategies. particular, this approach successful treatment most loading conditions especially transition thalassemia from fatal due protocols resulting complete elimination

Language: Английский

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Kidney-brain axis in the pathogenesis of cognitive impairment

Neurobiology of Disease, Journal Year: 2024, Volume and Issue: 200, P. 106626 - 106626

Published: Aug. 8, 2024

The kidney-brain axis is a bidirectional communication network connecting the kidneys and brain, potentially affected by inflammation, uremic toxin, vascular injury, neuronal degeneration, so on, leading to range of diseases. Numerous studies emphasize disruptions may contribute high morbidity neurological disorders, such as cognitive impairment (CI) in natural course chronic kidney disease (CKD). Although pathophysiology has not been fully elucidated, epidemiological data indicate that patients at all stages CKD have higher risk developing CI compared with general population. In contrast other reviews, we mentioned some commonly used medicines play pivotal role pathogenesis CI. Revealing interactions between damage brain function can reduce potential future This review will deeply explore characteristics, indicators, pathophysiological mechanisms CKD-related It provide theoretical basis for identifying progresses during ultimately prevents treats

Language: Английский

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Risk of fall in patients with chronic kidney disease: results from the China health and retirement longitudinal study (CHARLS)

BMC Public Health, Journal Year: 2024, Volume and Issue: 24(1)

Published: Feb. 16, 2024

Abstract Background Chronic kidney disease (CKD), often coexisting with various systemic disorders, may increase the risk of falls. Our study aimed to assess prevalence and falls among patients CKD in China. Methods We included with/without from China Health Retirement Longitudinal Study (CHARLS). primary outcome was occurrence fall accidents within past 2 years. To enhance robustness our findings, we employed a multivariable logistic regression model, conducted propensity score analysis, applied an inverse probability-weighting model. Results A total 12,658 participants were included, accident rates 17.1% (2,028/11,837) without 24.7% (203/821) those CKD. In exhibited higher (OR = 1.28, 95% CI: 1.08–1.53, p 0.005 ). Sensitivity subgroup analysis showed results still stable. Conclusions The population afflicted has significantly heightened experiencing falls, underscoring crucial importance intensifying efforts assessing preventing risks.

Language: Английский

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The Clock Drawing Task reveals executive dysfunction in the dialysis population – an underrecognized and underestimated problem

Renal Failure, Journal Year: 2024, Volume and Issue: 46(1)

Published: Jan. 26, 2024

Aim of the study The aimed to assess prevalence executive function impairment among patients with chronic kidney disease (CKD) undergoing dialysis, no subjective cognitive problems and normal global cognition on Mini-Mental State Examination (MMSE). We also investigated relationship between cardiovascular risk factors test results.

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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Exercise and Cognitive Function Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Efficacy and Harms

Clinical Journal of the American Society of Nephrology, Journal Year: 2024, Volume and Issue: 19(11), P. 1461 - 1472

Published: July 31, 2024

Key Points Cognitive impairment is common in CKD. Exercise targets multiple risk factors of cognitive decline. Meta-analysis found that exercise had a small but positive effect on function CKD, albeit the quality evidence was low. Further analyses revealed aerobic particularly beneficial and did not substantially increase harms. Background People living with CKD are at higher impairment. may improve function. This systematic review meta-analysis randomized controlled trials completed to determine efficacy harms improving people Methods A literature identified any stage an intervention exercised large-muscle groups, validated outcome measure First, were analyzed. Then random-effects subsequent planned subgroup investigate heterogeneity between stages treatments; different types, durations, intensities; methodologies. Finally, rated. Results Nineteen 1160 participants. Harms reported 94 occasions groups versus 83 control. The primary analysis statistically significant cognition (effect size=0.22; 95% confidence intervals, 0.00 0.44; P = 0.05). However, rated as Subgroup type moderated (chi square=7.62; 0.02), effects only observed following size=0.57; interval, 0.21 0.93; 0.002). Conclusions Across spectrum clinically meaningful seem be harmful. Aerobic beneficial. results must interpreted cautiously because low evidence. Nevertheless, care teams choose recommend interventions prevent Researchers should design unbiased studies clarify what intensity duration required maximize efficiency such interventions.

Language: Английский

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Cognitive Impairment in Chronic Kidney Disease Across Different Stages: The Role of Structural and Perfusion‐Driven Functional Connectivity Changes

Brain and Behavior, Journal Year: 2025, Volume and Issue: 15(2)

Published: Feb. 1, 2025

ABSTRACT Introduction Chronic kidney disease (CKD) is associated with cognitive impairment (CI), yet the exact pathophysiological mechanisms remain unclear. This study aims to investigate alterations in gray matter volume (GMV) and cerebral blood flow (CBF) across CKD stages, identify co‐changed brain regions, explore abnormal seed‐based functional connectivity (FC) patients CKD, correlation between regions neuropsychological test scores. Methods Two hundred eight participants (66 healthy controls, 70 Stages 1–3a, 72 3b–5) were consecutively recruited underwent high‐resolution T1‐weighted imaging, arterial spin labeling, MR imaging. The imaging parameters compared among three groups, correlations MoCA scores analyzed. Results Compared 1–3a group, bilateral fusiform gyrus (FFG.L FFG.R) exhibited reduced GMV, increased CBF, decreased FFG.L‐FC inferior frontal gyrus, triangular part (IFGtriang.L IFGtriang.R), left middle occipital (MOG.L), hippocampus (HIP.L), as well FFG.R‐FC median cingulate paracingulate gyri (DCG.L DCG.R), superior medial (SFGmed.L), IFGtriang.L, right temporal (MTG.R) 3b–5 group. A negative was observed (MFG.R), IFGtriang.R, HIP.L, putamen 1–3a. Conclusion Brain structural perfusion may underlie FC cognitive‐related providing potential neuroimaging evidence for neuropathological of CI different stages CKD.

Language: Английский

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Prevalence, associated factors and clinical implications of subjective cognitive decline linked to frailty in patients receiving maintenance hemodialysis: a cross-sectional study

BMC Nephrology, Journal Year: 2025, Volume and Issue: 26(1)

Published: Feb. 24, 2025

Subjective cognitive decline (SCD) significantly increases a patient's risk of long-term and is common in adults. However, few studies have evaluated patients with end-stage renal disease receiving maintenance hemodialysis (MHD). In addition, the relationship between frailty SCD MHD remains unclear. Therefore, this study aimed to assess potential factors affecting investigate SCD. This was cross-sectional study. From December 2023 April 2024, via convenience sampling method, total 171 from West China Hospital Sichuan University were recruited participate The demographic sociological characteristics participants assessed general information questionnaire. subjective questionnaire 9 (SCD-Q9), Tilburg indicator (TFI), global nutritional assessment (SGA) grip dynamometer used participants' level, frailty, status, strength, respectively. Univariate analyses examine associated Linear regression analyze relationships these Spearman's correlation association frailty. average score 4.00 (2.00–7.00), 95 (55.56%) scores > 3 presented analysis revealed that sex, work SGA, influential patients, explaining 38.80% variation positively correlated (r = 0.431, P < 0.001). prevalence correlates certain patient characteristics, including Healthcare workers should pay attention function population, remain aware for SCD, take targeted interventions as early possible, which can help improve quality survival slow occurrence impairment.

Language: Английский

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Chronic Kidney Disease and Cognitive Dysfunction after Cardiac Surgery

Cardiovascular Innovations and Applications, Journal Year: 2025, Volume and Issue: 10(1)

Published: Jan. 1, 2025

Patients with chronic kidney disease (CKD) often encounter cardiovascular complications, most commonly coronary heart disease. Although artery bypass grafting is an effective treatment for this condition, many patients experience cognitive dysfunction after cardiac surgery. The complex interactions among functional status, general anesthesia, cardiopulmonary bypass, and surgical trauma in CKD elevate the risk of neurological issues increase mortality rates Consequently, both quality life overall prognosis are significantly affected. By reviewing recent research on postoperative CKD, we sought to clarify underlying mechanisms affecting population gain theoretical insights help decrease perioperative occurrence.

Language: Английский

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Care pathways for patients with cognitive impairment and chronic kidney disease

Nephrology Dialysis Transplantation, Journal Year: 2025, Volume and Issue: 40(Supplement_2), P. ii28 - ii36

Published: March 1, 2025

ABSTRACT Various epidemiological datasets and pathophysiological hypotheses have highlighted a significant link between chronic kidney disease (CKD) cognitive impairment (CI); each condition can potentially exacerbate the other. Here, we review mutual consequences of CKD CI on health outcomes care pathways highlight complexities due to involvement different specialists. Our narrative covers (i) burden among patients with CKD, (ii) impact health, (iii) access replacement therapy for people CI, (iv) resources in (v) potential models integrated ‘nephro-cognitive’ care. (ranging from mild dementia) has older adults, high prevalence strong association CKD. Furthermore, complicates management leads higher mortality rate, poorer quality life healthcare costs. Due difficulties symptom description poor adherence medical guidelines, presence delay treatment Access both is hindered by physical, systemic barriers, resulting less intensive, timely Multidisciplinary approaches involving nephrologists, geriatricians, neurologists other specialists are crucial. Integrated focused person-centred approaches, shared decision-making continuous co-management may improve outcomes. Future research should focus putative beneficial effects these various strategies clinical patient-reported

Language: Английский

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