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Neurologic Complications of Chronic Kidney Disease

Kavitha Vellanki1, Vinod K Bansal

  • 1Department of Medicine, Division of Nephrology and Hypertension, Loyola University Medical Center, 2160 S. First Avenue, Bld 102 Room 3660, Maywood, IL, 60532, USA, kpotluri@lumc.edu.

Current Neurology and Neuroscience Reports
|June 18, 2015
PubMed

Insights

Chronic kidney disease (CKD) increases stroke risk, especially with atrial fibrillation (AF). Anticoagulation in CKD may help prevent stroke but requires careful monitoring due to bleeding risks.

Area of Science:

  • Nephrology
  • Cardiology
  • Neurology

Background:

  • Chronic kidney disease (CKD) is a growing global health concern.
  • CKD significantly elevates the risk of cardiovascular and cerebrovascular events, including stroke.
  • Patients with end-stage renal disease (ESRD) have a 3-fold increased incidence of stroke.

Purpose of the Study:

  • To review the relationship between CKD, atrial fibrillation (AF), and stroke risk.
  • To discuss the complexities of anticoagulation therapy in CKD patients with AF.
  • To highlight common neurological complications in CKD and their management.

Main Methods:

  • Review of observational evidence on anticoagulation in CKD and AF.
  • Analysis of neurological manifestations in CKD.
  • Discussion of drug dosing and management strategies.

Main Results:

  • Atrial fibrillation (AF) exacerbates stroke risk in CKD patients.
  • Evidence on anticoagulation benefits for stroke prevention in CKD is conflicting due to high bleeding risks.
  • Careful international normalized ratio (INR) monitoring is crucial for anticoagulation in CKD.

Conclusions:

  • Anticoagulation may be beneficial for selected CKD patients with AF, provided meticulous INR monitoring.
  • Neurological issues in CKD, such as those from electrolyte imbalances or uremia, require prompt diagnosis and management.
  • Optimizing drug dosing and awareness of side effects are vital for reducing morbidity and mortality in CKD.

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