| Theme |
Disorder of central nerve system in dialysis patients |
| Title |
Brain-kidney linkage in hemodialysis patients |
| Author |
Hideaki Shima |
Nephrology, Ohno Memorial Hospital |
| Author |
Toshihide Naganuma |
Urology, Osaka City University |
| Author |
Tetsuo Shoji |
Geriatrics and Vascular Medicine, Osaka City University |
| [ Summary ] |
Cardiovascular disease (CVD) refers to any condition which affects the cardiovascular system. This includes not only cardiac and peripheral artery diseasde but also cerebrovascular disease. Cerebrovascular disease is an important factor, particularly in the Japanese population. Chronic kidney disease (CKD) is a very high risk factor for cerebrovascular disease as well as cardiac disease. Asymptomatic or silent cerebrovascular disease （including lacunar stroke, microbleeds, and white matter lesions） are thought to precede symptomatic cerebrovascular disease or stroke, predicting future stroke, death, dementia or decline of ability in daily life (ADL). The prevalence of silent cerebrovascular disease is higher in the more advanced stages of CKD, suggesting a carry-over after initiation of dialysis. “Brain―kidney linkage” may be explained by a linkage through traditional and nontraditional risk factors, or by the "strain vessel hypothesis". Since hypertension is the most common and powerful risk factor for both the brain and kidney disease, it is very important to adequately control blood pressure, while avoiding excessive reduction. |