Cognitive impairment in chronic kidney disease: clinical findings, risk factors and consequences for patient care
Cognitive impairment in chronic kidney disease: clinical findings, risk factors and consequences for patient care
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DOI：
10.1007/s00702-014-1160-z
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发表时间：
2014-06-01
影响因子：
3.3
通讯作者：
Bruck, Heike
中科院分区：
文献类型：
--
作者：
Hermann, Dirk M.;Kribben, Andreas;Bruck, Heike
认知功能障碍在老年慢性肾脏病(CKD)患者中有很高的发生率。临床表现包括认知减慢、执行、记忆和语言障碍，并被归因于脑白质疾病和临床上经常无症状的脑梗塞。与此同时，有强有力的证据表明，低估计肾小球滤过率(CKD严重程度的衡量标准)除了人口统计因素、血管危险因素和疾病外，还容易导致认知缺陷、脑白质病变和缺血性脑梗塞，这些因素也导致CKD相关的认知障碍。在终末期慢性肾脏病中，血液透析过程中大脑血流量会受到影响，导致氧气减饱和、认知能力下降，从长远来看，还会导致脑萎缩。肾移植可改善终末期CKD患者的认知障碍。在所有阶段，血管危险因素和相关疾病都应严格按照治疗指南进行治疗。
Cognitive deficits have a high prevalence in elderly patients with chronic kidney disease (CKD). The clinical picture consists of cognitive slowing, executive, memory and language deficits, and is attributed to cerebral white matter disease and clinically often silent brain infarcts. In the meantime, robust evidence exists that low estimated glomerular filtration rate, a measure of CKD severity, predisposes to cognitive deficits, cerebral white matter lesions, and ischemic brain infarcts in addition to demographic factors, vascular risk factors and diseases which also contribute to CKD-related cognitive deficits. In terminal CKD, cerebral blood flow is compromized during hemodialysis sessions, resulting in oxygen desaturation, cognitive deterioration and-in the longer run-brain atrophy. Kidney transplantation improves cognitive deficits in terminal CKD. At all stages, vascular risk factors and associated diseases should stringently be treated according to therapeutic guidelines.