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Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats
Published on: March 11, 2016
Disentangling the multiple links between renal dysfunction and cerebrovascular disease
Dearbhla Kelly1, Peter Malcolm Rothwell2
1Centre for the Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK Dearbhla.Kelly@ndcn.ox.ac.uk.
Insights
Chronic kidney disease (CKD) significantly increases stroke risk. This review explores the link between kidney disease and cerebrovascular issues, including potential causes and impacts on stroke treatment.
Area of Science:
- Nephrology and Neurology
- Epidemiology of Chronic Diseases
- Cardiovascular and Cerebrovascular Health
Background:
- Chronic kidney disease (CKD) prevalence is rising globally, particularly in older adults.
- CKD is a significant risk factor for cardiovascular disease, especially stroke.
- Associations exist between CKD and subclinical cerebrovascular abnormalities, cognitive impairment, and dementia.
Purpose of the Study:
- To review the current understanding of cerebrovascular disease epidemiology in CKD patients.
- To explore the pathophysiology linking CKD to cerebrovascular complications.
- To discuss the role of traditional and non-traditional risk factors in this association.
Main Methods:
- Review of cohort studies and clinical trials.
- Analysis of epidemiological data on CKD and stroke incidence.
- Examination of pathophysiological mechanisms and risk factors.
Main Results:
- Reduced glomerular filtration rate increases stroke risk by approximately 40%.
- Proteinuria elevates stroke risk by approximately 70%.
- CKD is linked to both traditional (hypertension, diabetes) and non-traditional (uremia, oxidative stress) risk factors.
Conclusions:
- CKD poses a substantial risk for cerebrovascular disease, including stroke and cognitive decline.
- Multiple traditional and non-traditional factors contribute to the CKD-cerebrovascular link.
- Understanding these mechanisms is crucial for managing stroke risk and treatment in CKD patients.
Abstract:
Chronic kidney disease (CKD) has a rapidly rising global prevalence, affecting as many as one-third of the population over the age of 75 years. CKD is a well-known risk factor for cardiovascular disease and, in particular, there is a strong association with stroke. Cohort studies and trials indicate that reduced glomerular filtration rate increases the risk of stroke by about 40% and that proteinuria increases the risk by about 70%. In addition, CKD is also strongly associated with subclinical cerebrovascular abnormalities, vascular cognitive impairment and dementia. The mechanisms responsible for these associations are currently unclear. CKD is associated with traditional risk factors such as hypertension, diabetes mellitus and atrial fibrillation, but non-traditional risk factors such as uraemia, oxidative stress, mineral and bone abnormalities, and dialysis-related factors, such as changes in cerebral blood flow or cardiac structure, are also postulated to play a role. Kidney disease can also impact and complicate the treatments used in acute stroke and in secondary prevention. In this review, we will outline our current understanding of the epidemiology and pathophysiology of cerebrovascular disease in CKD.
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