Brain-kidney interaction: Renal dysfunction following ischemic stroke

J Cereb Blood Flow Metab. 2020 Feb;40(2):246-262. doi: 10.1177/0271678X19890931. Epub 2019 Nov 25.


Stroke is a leading cause of mortality and morbidity, with long-term debilitating effects. Accumulating evidence from experimental studies as well as observational studies in patients suggests a cross talk between the brain and kidney after stroke. Stroke may lead to kidney dysfunction which can adversely impact patient outcome. In this review article, we discuss the epidemiology and mechanisms of brain–kidney interaction following ischemic stroke. Specifically, we discuss the role of the central autonomic network, autoregulation, inflammatory and immune responses, the role of extracellular vesicles and their cargo microRNA, in mediating brain–kidney interaction following stroke. Understanding the bidirectional nature of interaction between the brain and kidney after cerebral injury would have clinical implications for the treatment of stroke and overall patient outcome.

Keywords: Acute kidney injury; chronic kidney disease; extracellular vesicles; immune response; ischemic stroke.

Publication types

  • Review

MeSH terms

  • Brain Ischemia* / blood
  • Brain Ischemia* / complications
  • Brain Ischemia* / immunology
  • Brain Ischemia* / therapy
  • Brain* / immunology
  • Brain* / metabolism
  • Brain* / pathology
  • Extracellular Vesicles / immunology
  • Extracellular Vesicles / metabolism
  • Humans
  • Kidney Diseases* / blood
  • Kidney Diseases* / etiology
  • Kidney Diseases* / immunology
  • Kidney Diseases* / therapy
  • Kidney* / immunology
  • Kidney* / metabolism
  • Kidney* / pathology
  • MicroRNAs / blood
  • MicroRNAs / immunology
  • Stroke* / blood
  • Stroke* / complications
  • Stroke* / immunology
  • Stroke* / therapy


  • MicroRNAs