Abstract
BackgroundNeurological complications may occur in patients with acute or chronic renal failure; however, in cases of acute renal failure, the signs and symptoms are usually more pronounced, and progressed rapidly. Oxidative stress and nitric oxide in the hippocampus, following kidney injury may be involved in cognitive impairment in patients with uremia. Although many women continue taking hormone therapy for menopausal symptom relief, but there are also some controversies about the efficacy of exogenous sex hormones, especially estrogen therapy alone, in postmenopausal women with kidney injury. Herein, to the best of our knowledge for the first time, spatial memory and synaptic plasticity at the CA1 synapse of a uremic ovariectomized rat model of menopause was characterized by estradiol replacement alone.ResultsWhile estradiol replacement in ovariectomized rats without uremia, promotes synaptic plasticity, it has an impairing effect on spatial memory through hippocampal oxidative stress under uremic conditions, with no change on synaptic plasticity. It seems that exogenous estradiol potentiated the deleterious effect of acute kidney injury (AKI) with increasing hippocampal oxidative stress.ConclusionsAlthough, estrogen may have some positive effects on cognitive function in healthy subjects, but its efficacy in menopause subjects under uremic states such as renal transplantation, needs to be further investigated in terms of dosage and duration.
Highlights
Neurological complications may occur in patients with acute or chronic renal failure; in cases of acute renal failure, the signs and symptoms are usually more pronounced, and progressed rapidly
Water maze Global analysis revealed that latency to reach the platform was progressively and significantly reduced over the 4 days of training in all experimental groups, indicating spatial acquisition (Block effect, F (3, 102) = 34.86, P < 0.001, two-way repeated measures analysis of variance (ANOVA))
In cumulative acquisition trials of 4 days (Fig. 1b), a statistically significant difference was found between Acute kidney injury (AKI) group in comparison to the sham group (28.72 ± 2.7 s and 20.83 ± 1.82 s respectively; P < 0.05), and between the sham treated with estrogen, compared to those in sham-vehicle rats (30.42 ± 2.33 s and 20.83 ± 1.82 s respectively; P < 0.05)
Summary
Neurological complications may occur in patients with acute or chronic renal failure; in cases of acute renal failure, the signs and symptoms are usually more pronounced, and progressed rapidly. Oxidative stress and nitric oxide in the hippocampus, following kidney injury may be involved in cognitive impairment in patients with uremia. Many women continue taking hormone therapy for menopausal symptom relief, but there are some controversies about the efficacy of exogenous sex hormones, especially estrogen therapy alone, in postmenopausal women with kidney injury. While some reports indicated more deterioration by administration of estrogen [11, 12], others reported an improvement of renal function [13, 14]. These disparities may be due to the differences between various animal models of renal injury or differences in the type, dosage or mode of estrogen treatment administered
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