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- Pepin, Marion, et al.
(author)
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Cognitive disorders in patients with chronic kidney disease: Approaches to prevention and treatment
- 2023
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In: European Journal of Neurology. - : WILEY. - 1351-5101 .- 1468-1331. ; 30:9, s. 2899-2911
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Research review (peer-reviewed)abstract
- Background: Cognitive impairment is common in patients with chronic kidney disease (CKD), and early intervention may prevent the progression of this condition. Methods: Here, we review interventions for the complications of CKD (anemia, secondary hyperparathyroidism, metabolic acidosis, harmful effects of dialysis, the accumulation of uremic toxins) and for prevention of vascular events, interventions that may potentially be protective against cognitive impairment. Furthermore, we discuss nonpharmacological and pharmacological methods to prevent cognitive impairment and/or minimize the latters impact on CKD patients daily lives. Results: A particular attention on kidney function assessment is suggested during work-up for cognitive impairment. Different approaches are promising to reduce cognitive burden in patients with CKD but the availabe dedicated data are scarce. Conclusions: There is a need for studies assessing the effect of interventions on the cognitive function of patients with CKD.
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2. |
- Hafez, Gaye, et al.
(author)
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Drugs with a negative impact on cognitive functions (Part 2): drug classes to consider while prescribing in CKD patients
- 2023
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In: Clinical Kidney Journal. - : OXFORD UNIV PRESS. - 2048-8505 .- 2048-8513. ; 16:12, s. 2378-2392
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Research review (peer-reviewed)abstract
- There is growing evidence that chronic kidney disease (CKD) is an independent risk factor for cognitive impairment, especially due to vascular damage, blood-brain barrier disruption and uremic toxins. Given the presence of multiple comorbidities, the medication regimen of CKD patients often becomes very complex. Several medications such as psychotropic agents, drugs with anticholinergic properties, GABAergic drugs, opioids, corticosteroids, antibiotics and others have been linked to negative effects on cognition. These drugs are frequently included in the treatment regimen of CKD patients. The first review of this series described how CKD could represent a risk factor for adverse drug reactions affecting the central nervous system. This second review will describe some of the most common medications associated with cognitive impairment (in the general population and in CKD) and describe their effects. Graphical Abstract
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