| [ Summary ] |
Recently, it has been reported that the prevalence of cognitive impairment (CI) is high in chronic kidney disease (CKD) patients. This is true whether they require renal replacement therapy or not, even if they seem to show no uremic symptoms and exhibit stable cognitive functionality. It has recently been reported that CI, which may result from a variety of risk factors such as aging, hypertension and anemia, is an independent predictor of mortality in dialysis patients. Patients with CI in CKD predominantly develop executive impairment, which is characteristically found in vascular-type CI, rather than memory impairment, which is characteristically found in Alzheimer-type CI. Thus, it is considered that the etiology of CI in CKD patients may be primarily attributed to vascular changes such as lacunar infarction or chronic ischemia, which are recognized as being associated with white matter hyperlucency observed in MRIs of the brain. It has also been demonstrated in many reports that CI may be reduced by treating anemia with erythropoiesis-stimulating agents and renal transplantation. On the other hand, there is controversy as to the effects of increased dialysis dosage and frequency in relation to CI. Further examination is required to elucidate the pathogenesis of CI in CKD patients. |