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Updated: Oct 17, 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
1Department of Geriatrics, Ambroise Paré Hospital, 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
|October 6, 2021
Summary
Chronic kidney disease (CKD) is linked to neurocognitive disorders (NCDs) due to shared risk factors and kidney-specific mechanisms. Early cognitive assessment is crucial for older CKD patients to guide treatment decisions.
Area of Science:
- Nephrology
- Neurology
- Geriatrics
Background:
- Chronic kidney disease (CKD) affects 25% of individuals over 70.
- Neurocognitive disorders (NCDs) impact 30-60% of patients undergoing haemodialysis.
- CKD-NCD link involves common (hypertension, diabetes) and CKD-specific (vascular, degenerative, toxic) factors.
Purpose of the Study:
- To explore the relationship between chronic kidney disease and neurocognitive disorders.
- To identify risk factors and affected cognitive domains in CKD patients.
- To discuss preventative strategies and management considerations for NCDs in CKD.
Main Methods:
- Review of existing literature on CKD and NCDs.
- Analysis of risk factors including albuminuria and glomerular filtration rate.
- Examination of specific NCD types like vascular dementia and Alzheimer's disease in CKD populations.
Main Results:
- Albuminuria is a stronger predictor of NCDs than GFR in non-dialysed CKD patients.
- Vascular dementia is the primary NCD in CKD; Alzheimer's disease incidence is also elevated in end-stage renal disease (ESRD).
- Executive functions, orientation, and attention are the most commonly impaired cognitive domains.
Conclusions:
- NCDs in older CKD patients may be preventable through blood pressure control and anticoagulation for atrial fibrillation.
- Nephrological care can influence neurological complications; caution is advised with certain cognitive medications due to accumulation in CKD.
- Cognitive assessment is recommended for severe CKD patients to inform renal replacement therapy discussions.
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