Cognitive disorders in patients with chronic kidney disease: Approaches to prevention and treatment
Marion Pépin, Aleksandra Klimkowicz‐Mrowiec, Olivier Godefroy, Pilar Delgado, Sol Carriazo, Ana Carina Ferreira, Aleksandra Golenia, Jolanta Małyszko, Tomasz Grodzicki, Konstantinos Giannakou, Giuseppe Paolisso, Michelangela Barbieri, Liliana Gârneaţă, Carmen-Antonia Mocanu, Sophie Liabeuf, Goce Spasovski, Carmine Zoccali, Annette Bruchfeld, Ana Farinha, Mustafa Arıcı, Giovambattista Capasso, Andrzej Więcek, Ziad A. Massy, the CONNECT (Cognitive Decline in Nephro‐Neurology: European Cooperative Target) Action
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 latter's 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.