Chronic Kidney Disease and Cognitive Impairment

Chronic kidney disease (CKD) is associated with a high risk of cognitive impairment (CI). Both vascular and metabolic factors are implicated in the causation of CI in CKD. The traditional risk factors for CI are more prevalent in CKD and interact reciprocally. CI in CKD is associated with reduced functional capacity, poor quality of life and mor-tality. Cognition declines significantly after initiation of haemodialysis (HD). Repeated cerebral insults related to intra-dialytic haemodynamic instability may be responsible for the rapid, step-wise decline in cognition observed in HD patients. Cognitive inter-ventions used in the general population have not been adequately tested in CKD. Exer-cise interventions are likely to be beneficial based on biological plausibility and pilot trial data. Cooled HD may be beneficial in HD patients but needs substantive trial data to support it. Cognition testing should be routinely offered to CKD patients. There is a need for further research into the underlying causes of CI in CKD with a view to devel-oping therapeutic interventions.

Automated summary

Chronic kidney disease is closely associated with cognitive impairment, with vascular and metabolic factors playing a role. Cognitive impairment in CKD leads to reduced functional capacity, decreased quality of life, and increased mortality. Further research is needed to develop therapeutic interventions for cognitive decline in CKD patients, especially those undergoing hemodialysis.