Progress of research on the mechanism of chronic kidney disease-related cognitive impairment

doi:10.3877/cma.j.issn.2095-3216.2023.03.008

Abstract

Abstract:

Patients with chronic kidney disease (CKD) generally have progressive renal decline and endocrinologic and metabolic derailments, resulting in oxidative stress, endothelial dysfunction, vascular calcification, uremic toxin retention, dysfunction of cerebral blood flow autoregulation, and impairment of neural precursor cells. Therefore, individuals at all stages of chronic kidney disease (CKD) have a higher risk of developing cognitive impairment (CI). However, the underlying mechanism for CKD-related CI remains incompletely understood. Meanwhile, effective therapeutic interventions for CKD-related CI are lacking. Cognitive dysfunction has been linked to poor compliance with medications, and is associated with greater mortality. Thus, understanding the pathogenesis of CKD-related CI and developing effective therapeutic interventions is important to minimize the risk of cognitive injury in patients with CKD. This review summarized the progress of research on the molecular and cellular mechanisms involved in the pathogenesis of CI following CKD.

Key words: Cognitive impairment, Chronic kidney disease, Inflammation, Uremic toxin

Shiyuan Wang, Aihua Zhang. Progress of research on the mechanism of chronic kidney disease-related cognitive impairment[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2023, 12(03): 163-167.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhsbyjdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3216.2023.03.008

https://zhsbyjdzzz.cma-cmc.com.cn/EN/Y2023/V12/I03/163

Figures/Tables 1

References 54

[1]	Bikbov B, Purcell C, Levey AS, et al. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017 [J]. Lancet, 2020, 395(10225): 709-733.
[2]	Kalantar-Zadeh K, Jafar TH, Nitsch D, et al. Chronic kidney disease [J]. Lancet, 2021, 398(10302): 786-802.
[3]	Berger I, Wu S, Masson P, et al. Cognition in chronic kidney disease: a systematic review and meta-analysis [J]. BMC Med, 2016, 14(1): 206.
[4]	Seliger SL, Wendell CR, Waldstein SR, et al. Renal function and long-term decline in cognitive function: the Baltimore Longitudinal Study of Aging [J]. Am J Nephrol, 2015, 41(4-5): 305-312.
[5]	Etgen T, Chonchol M, Förstl H, et al. Chronic kidney disease and cognitive impairment: a systematic review and meta-analysis [J]. Am J Nephrol, 2012, 35(5): 474-482.
[6]	Viggiano D, Wagner CA, Martino G, et al. Mechanisms of cognitive dysfunction in CKD [J]. Nat Rev Nephrol, 2020, 16(8): 452-469.
[7]	Raphael KL, Wei G, Greene T, et al. Cognitive function and the risk of death in chronic kidney disease [J]. Am J Nephrol, 2012, 35(1): 49-57.
[8]	Griva K, Stygall J, Hankins M, et al. Cognitive impairment and 7-year mortality in dialysis patients [J]. Am J Kidney Dis, 2010, 56(4): 693-703.
[9]	van ZA, Wong G, Ruospo M, et al. Associations of cognitive function and education level with all-cause mortality in adults on hemodialysis: findings from the COGNITIVE-HD Study [J]. Am J Kidney Dis, 2019, 74(4): 452-462.
[10]	Marcos G, Santabárbara J, Lopez-Anton R, et al. Conversion to dementia in mild cognitive impairment diagnosed with DSM-5 criteria and with Petersen′s criteria [J]. Acta Psychiatr Scand, 2016, 133(5): 378-385.
[11]	Armstrong A. Risk factors for Alzheimer′s disease [J]. Folia Neuropathol, 2019, 57(2): 87-105.
[12]	Lipnicki DM, Crawford J, Kochan NA, et al. Risk factors for mild cognitive impairment, dementia and mortality: the Sydney memory and ageing study [J]. J Am Med Dir Assoc, 2017, 18(5): 388-395.
[13]	Tamura MK, Yaffe K. Dementia and cognitive impairment in ESRD: diagnostic and therapeutic strategies [J]. Kidney Int, 2011, 79(1): 14-22.
[14]	Kuo YT, Li CY, Sung JM, et al. Risk of dementia in patients with end-stage renal disease under maintenance dialysis-a nationwide population-based study with consideration of competing risk of mortality [J]. Alzheimers Res Ther, 2019, 11(1): 1-12.
[15]	Drew DA, Weiner DE, Sarnak MJ. Cognitive impairment in CKD: pathophysiology, management, and prevention [J]. Am J Kidney Dis, 2019, 74(6): 782-790.
[16]	Lin YT, Wu PH, Liang SS, et al. Protein-bound uremic toxins are associated with cognitive function among patients undergoing maintenance hemodialysis [J]. Sci Rep, 2019, 9(1): 20388.
[17]	Ravid JD, Kamel MH, Chitalia VC. Uraemic solutes as therapeutic targets in CKD-associated cardiovascular disease [J]. Nat Rev Nephrol, 2021, 17(6): 402-416.
[18]	Walker JA, Richards S, Belghasem ME, et al. Temporal and tissue-specific activation of aryl hydrocarbon receptor in discrete mouse models of kidney disease [J]. Kidney Int, 2020, 97(3): 538-550.
[19]	Dou L, Sallée M, Cerini C, et al. The cardiovascular effect of the uremic solute indole-3 acetic acid [J]. J Am Soc Nephrol, 2015, 26(4): 876-887.
[20]	Adesso S, Paterniti I, Cuzzocrea S, et al. AST-120 reduces neuroinflammation induced by indoxyl sulfate in glial cells [J]. J Clin Med, 2018, 7(10): 365.
[21]	Tsuruya K, Yoshida H. Brain atrophy and cognitive impairment in chronic kidney disease [J]. Contrib Nephrol, 2018, 196: 27-36.
[22]	Lee JH, Yoon YM, Lee SH. TUDCA-treated mesenchymal stem cells protect against ER stress in the hippocampus of a murine chronic kidney disease model [J]. Int J Mol Sci, 2019, 20(3): 613.
[23]	Miller LM, Rifkin D, Lee AK, et al. Association of urine biomarkers of kidney tubule injury and dysfunction with frailty index and cognitive function in persons with CKD in SPRINT [J]. Am J Kidney Dis, 2021, 78(4): 530-540.
[24]	Lidgard B, Bansal N, Zelnick LR, et al. Association of proximal tubular secretory clearance with long-term decline in cognitive function [J]. J Am Soc Nephrol, 2022, 33(7): 1391-1401.
[25]	Cunningham C, Hennessy E. Co-morbidity and systemic inflammation as drivers of cognitive decline: new experimental models adopting a broader paradigm in dementia research [J]. Alzheimers Res Ther, 2015, 7(1): 33.
[26]	Tamura MK, Tam K, Vittinghoff E, et al. Inflammatory markers and risk for cognitive decline in chronic kidney disease: the CRIC study [J]. Kidney Int Rep, 2017, 2(2): 192-200.
[27]	Meng C, Zhang JC, Shi RL, et al. Inhibition of interleukin-6 abolishes the promoting effects of pair housing on post-stroke neurogenesis [J]. Neuroscience, 2015, 307: 160-170.
[28]	Huang C, Irwin MG, Wong GTC, et al. Evidence of the impact of systemic inflammation on neuroinflammation from a non-bacterial endotoxin animal model [J]. J Neuroinflammation, 2018, 15(1): 147.
[29]	Sedaghat S, Vernooij MW, Loehrer E, et al. Kidney function and cerebral blood flow: the rotterdam study [J]. J Am Soc Nephrol, 2016, 27(3): 715-721.
[30]	Miyazawa H, Ookawara S, Ito K, et al. Association of cerebral oxygenation with estimated glomerular filtration rate and cognitive function in chronic kidney disease patients without dialysis therapy [J]. PLoS One, 2018, 13(6): e0199366.
[31]	Kovarova L, Valerianova A, Kmentova T, et al. Low cerebral oxygenation is associated with cognitive impairment in chronic hemodialysis patients [J]. Nephron, 2018, 139(2): 113-119.
[32]	Findlay MD, Dawson J, Dickie DA, et al. Investigating the relationship between cerebral blood flow and cognitive function in hemodialysis patients [J]. J Am Soc Nephrol, 2019, 30(1): 147-158.
[33]	Eldehni MT, Odudu A, McIntyre CW. Randomized clinical trial of dialysate cooling and effects on brain white matter [J]. J Am Soc Nephrol, 2015, 26(4): 957-965.
[34]	Aggarwal HK, Jain D, Bhavikatti A. Cognitive dysfunction in patients with chronic kidney disease [J]. Saudi J Kidney Dis Transpl, 2020, 31(4): 796-804.
[35]	Lourida I, Thompson-Coon J, Dickens CM, et al. Parathyroid hormone, cognitive function and dementia: a systematic review [J]. PLoS One, 2015, 10(5): e0127574.
[36]	Kuriyama N, Ozaki E, Mizuno T, et al. Association between α-Klotho and deep white matter lesions in the brain: a pilot case control study using brain MRI [J]. J Alzheimers Dis, 2018, 61(1): 145-155.
[37]	McGrath ER, Himali JJ, Levy D, et al. Circulating fibroblast growth factor 23 levels and incident dementia: the Framingham heart study [J]. PLoS One, 2019, 14(3): e0213321.
[38]	Mayne PE, Burne THJ. Vitamin D in synaptic plasticity, cognitive function, and neuropsychiatric illness [J]. Trends Neurosci, 2019, 42(4): 293-306.
[39]	Mazumder MK, Paul R, Bhattacharya P, et al. Neurological sequel of chronic kidney disease: from diminished acetylcholinesterase activity to mitochondrial dysfunctions, oxidative stress and inflammation in mice brain [J]. Sci Rep, 2019, 9(1): 3097.
[40]	Kim JW, Ha GY, Jung YW. Chronic renal failure induces cell death in rat hippocampal CA1 via upregulation of αCaMKII/NR2A synaptic complex and phosphorylated GluR1-containing AMPA receptor cascades [J]. Kidney Res Clin Pract, 2014, 33(3): 132-138.
[41]	Iliff JJ, Wang M, Liao Y, et al. A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid β [J]. Sci Transl Med, 2012, 4(147): 147ra111.
[42]	Heo CM, Lee DA, Park KM, et al. Glymphatic system dysfunction in patients with early chronic kidney disease [J]. Front Neurol, 2022, 13: 976089.
[43]	Heo CM, Lee WH, Park BS, et al. Glymphatic dysfunction in patients with end-stage renal disease [J]. Front Neurol, 2022, 12: 809438.
[44]	Rasmussen MK, Mestre H, Nedergaard M. The glymphatic pathway in neurological disorders [J]. Lancet Neurol, 2018, 17(11): 1016-1024.
[45]	Jiang Q, Zhang L, Ding G, et al. Impairment of the glymphatic system after diabetes [J]. J Cereb Blood Flow Metab, 2017, 37(4): 1326-1337.
[46]	Mortensen KN, Sanggaard S, Mestre H, et al. Impaired glymphatic transport in spontaneously hypertensive rats [J]. J Neurosci, 2019, 39(32): 6365-6377.
[47]	Verbitsky M, Kogon AJ, Matheson M, et al. Genomic disorders and neurocognitive impairment in pediatric CKD [J]. J Am Soc Nephrol, 2017, 28(8): 2303-2309.
[48]	Mengel-From J, Soerensen M, Nygaard M, et al. Genetic variants in klotho associate with cognitive function in the oldest old group [J]. J Gerontol A Biol Sci Med Sci, 2016, 71(9): 1151-1159.
[49]	Joshee P, Wood AG, Wood ER, et al. Meta-analysis of cognitive functioning in patients following kidney transplantation [J]. Nephrol Dial Transplant, 2018, 33(7): 1268-1277.
[50]	Lepping RJ, Montgomery RN, Sharma P, et al. Normalization of cerebral blood flow, neurochemicals, and white matter integrity after kidney transplantation [J]. J Am Soc Nephrol, 2021, 32(1): 177-187.
[51]	McAfoose J, Baune BT. Evidence for a cytokine model of cognitive function [J]. Neurosci Biobehav Rev, 2009, 33(3): 355-366.
[52]	Skardelly M, Glien A, Groba C, et al. The influence of immunosuppressive drugs on neural stem/progenitor cell fate in vitro [J]. Exp Cell Res, 2013, 319(20): 3170-3181.
[53]	Kashgary A, Khojah A, Bamalan B, et al. Effect of hemodiafiltration versus hemodialysis on cognitive function among patients with end-stage renal disease: a multicenter study [J]. Cureus, 2021, 13(11): e19719.
[54]	Lin YT, Wu PH, Kuo MC, et al. Comparison of dementia risk between end stage renal disease patients with hemodialysis and peritoneal dialysis-a population based study [J]. Sci Rep, 2015, 5: 8224.

Please choose a citation manager

Content to export