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Updated: Dec 1, 2025
07:30
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
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[Chronic kidney disease and cognitive impairment]
Marion Pépin1, Cédric Villain2
1Service de gériatrie, Hôpital Ambroise Paré, AP-HP, Boulogne-Billancourt, France, Centre de recherche en épidémiologie et santé des populations (CESP), Équipe épidémiologie clinique, Université Paris-Saclay, Université Versailles Saint-Quentin-en-Yvelines (UVSQ), Inserm UMRS 1018, Villejuif, France.
Geriatrie Et Psychologie Neuropsychiatrie Du Vieillissement
|November 6, 2020
Summary
Chronic kidney disease (CKD) is linked to cognitive impairment (CI) in older adults. Managing CKD risk factors and cognitive health is crucial for better patient outcomes.
Area of Science:
- Nephrology
- Neurology
- Geriatrics
Background:
- Chronic kidney disease (CKD) affects 25% of individuals over 70.
- Cognitive impairment (CI) is prevalent in 30-60% of hemodialysis patients.
- CKD-CI link involves shared risk factors (hypertension, diabetes) and CKD-specific mechanisms (vascular, degenerative, toxic).
Purpose of the Study:
- To review the relationship between CKD and CI.
- To identify risk factors and affected cognitive domains in CKD patients.
- To discuss preventive strategies and management considerations for CI in CKD.
Main Methods:
- Literature review focusing on CKD and cognitive impairment.
- Analysis of risk factors, including albuminuria and glomerular filtration rate.
- Examination of cerebrovascular and neurodegenerative pathways linking CKD and CI.
Main Results:
- Albuminuria is a stronger predictor of CI than GFR in non-dialyzed CKD.
- Vascular dementia is the primary cause of CI in CKD; Alzheimer's disease incidence is also elevated in end-stage kidney disease.
- Executive functions, orientation, and attention are the most affected cognitive domains.
Conclusions:
- Controlling blood pressure and using anticoagulants for atrial fibrillation may prevent CI in CKD patients.
- Nephrological care can influence neurological complications; caution is advised with certain medications in CKD.
- Cognitive assessment is recommended for severe CKD patients to guide renal replacement therapy decisions.
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