Abstract
Patients with chronic kidney disease (CKD) are well known to have a higher prevalence of cardiovascular disease from epidemiological studies. Recently, CKD has also been shown to be related to neurological disorders, not only ischemic brain injury but also cognitive impairment. This cerebrorenal connection is considered to involve small vessel disease in both the kidney and brain, based on their hemodynamic similarities. Clinical studies suggest that markers for CKD such as estimated glomerular filtration rate (eGFR), proteinuria, and albuminuria may be helpful to predict brain small vessel disease, white matter lesions (WMLs), silent brain ischemia (SBI), and microhemorrhages. Recently, changes in the vascular system of the brain have been shown to contribute to the onset and progression of cognitive impairment, not only vascular dementia but also Alzheimer's disease. Patients with CKD are also reported to have higher risk of impaired cognitive function in the future compared with non-CKD subjects. These results indicate that CKD markers may be helpful to predict the future risk of neuronal disease.
Highlights
The relation between chronic kidney disease (CKD) and neurological disorders, cerebrovascular disease such as ischemic brain injury and cognitive impairment such as Alzheimer’s disease, has been highlighted
Patients with cerebral small vessel disease and impaired kidney function exhibit poor poststroke survival [5]. These results indicate that Representative cerebral small vessel diseases include white matter lesions (WMLs), silent brain infarction (SBI), and microhemorrhages as well as lacunar infarcts and subcortical atrophy
Ikram et al investigated the relation between kidney function evaluated by estimated glomerular filtration rate (eGFR) and cerebral small vessel disease via MRI analysis. They clearly showed that decreased eGFR was related to subclinical markers of cerebral small vessel disease such as deep white matter volume and WNLs independent of cardiovascular risk factors such as age, sex, blood pressure, and diabetes [12]
Summary
The relation between chronic kidney disease (CKD) and neurological disorders, cerebrovascular disease such as ischemic brain injury and cognitive impairment such as Alzheimer’s disease, has been highlighted. This cerebrorenal interaction is considered to be based on small vessel disease. Cerebral and glomerular small vessel disease might have a common soil of pathogenesis, as these organs are closely connected with each other through anatomic and vasoregulatory similarities. Damage markers in the brain could be magnetic resonance imaging- (MRI-) documented small vessel alterations. Clinical investigations have suggested a relation between these damage markers in the kidney and the brain. We review the cerebrorenal interactions mainly from a clinical view
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