Neurological disorders in patients with chronic kidney disease

Sinyuhin V.N., Rabinovich E.Z., Sokolov M.A., Sivkov A.V.

Chronic kidney disease (CKD) is followed by a series of neurological complications, which affect all parts of the nervous system. Among the disorders of the central nervous system are stroke, cognitive disorders, encephalopathy and dementia. Peripheral nervous system is mostly affected by autonomous and peripheral neuropathies. Understanding of pathophysiological mechanisms of these disorders can help for their effective treatment. There are two hypotheses, vascular and neurodegenerative, which explain the diseases of the nervous system in patients with CKD. According to the vascular hypothesis, patients with CKD have not only conventional risk factors of nervous diseases, such as hypertonia, hypercholesterolemia, old age, smoking and diabetes, but also factors, which are typical for renal failure — metabolic disorders, inflammation, hypercoagulation and oxidative stress. These factors lead to the increase in endothelial dysfunction, accelerate processes of vascular deformation and cause nervous disorders. According to the other hypothesis, accumulation of uremic toxins, anemia, high levels of parathormone mostly determine the pathogenesis of vascular and nervous disorders in patients with CKD. Many clinical and laboratory studies have demonstrated that the changes in the nervous system in patients with CKD have multifactorial character. This allows us to claim that, apart from identical anatomical patterns of brain and kidney vessels, they also share similarity in their regulation, have mutual influence and bidirectional action of humoral and non-humoral ways of regulation of physiological processes, which ultimately affect the performance of brain and kidney. There is no doubt that treatment of patients with CKD leads to the decrease in the probability of emergence of all kinds of neurological disorders and will reduce their intensity.

Authors declare lack of the possible conflicts of interests.

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chronic kidney disease, neurological complications, stroke, neuropathy, еncephalopathy, dementia, cognitive disorders