Cognitive disorders and dementia in CKD: the neglected kidney-brain axis

J Am Soc Nephrol. 2013 Feb;24(3):353-63. doi: 10.1681/ASN.2012050536. Epub 2013 Jan 4.


Epidemiologic data suggest that individuals at all stages of CKD have a higher risk of developing cognitive disorders and dementia. This risk is generally explained by the high prevalence of both symptomatic and subclinical ischemic cerebrovascular lesions. However, other potential mechanisms, including direct neuronal injury by uremic toxins, could also be involved, especially in the absence of obvious cerebrovascular disease. We discuss the prevalence and characteristics of cognitive disorders and dementia in patients with CKD, brain imaging findings, and traditional and nontraditional risk factors. Understanding the pathophysiologic interactions between renal impairment and brain function is important in order to minimize the risk for future cognitive impairment.

Publication types

  • Review

MeSH terms

  • Brain / pathology
  • Cerebrovascular Disorders / etiology
  • Cognition Disorders / epidemiology
  • Cognition Disorders / etiology*
  • Dementia / epidemiology
  • Dementia / etiology*
  • Humans
  • Kidney Failure, Chronic / complications
  • Models, Neurological
  • Neurodegenerative Diseases / etiology
  • Neurodegenerative Diseases / pathology
  • Prevalence
  • Renal Insufficiency, Chronic / complications*
  • Stroke / etiology