Neuropsychiatric disorders in chronic kidney disease

Ana Cristina Simões Silva, Aline Silva Miranda, Natalia Pessoa Rocha, Antônio Lúcio Teixeira

Research output: Contribution to journalReview articlepeer-review

59 Scopus citations

Abstract

Neuropsychiatric conditions including depression, anxiety disorders, and cognitive impairment are prevalent in patients with chronic kidney disease (CKD). These conditions often make worse the quality of life and also lead to longer hospitalizations and higher mortality. Over the past decades, some hypotheses have tried to explain the connection between CKD and neuropsychiatric disorders. The most common hypothesis is based on the occurrence of cerebrovascular disease and accumulated uremic toxins in adult patients with CKD. However, the lack of a direct association between known vascular risk factors (e.g., diabetes and hypertension) with CKD-related cognitive deficits suggests that other mechanisms may also play a role in the pathophysiology shared by renal and neuropsychiatric diseases. This hypothesis is corroborated by the occurrence of neuropsychiatric comorbidities in pediatric patients with CKD preceding vascular damage, and the inconsistent findings on neuroprotective effects of antihypertensives. The aim of this narrative review was to summarize clinical evidence and potential mechanisms that links CKD and brain disorders, specifically in regard to cognitive impairment, anxiety, and depression.

Original languageEnglish (US)
Article number932
JournalFrontiers in Pharmacology
Volume10
Issue numberJULY
DOIs
StatePublished - 2019
Externally publishedYes

Keywords

  • Anxiety
  • Cerebrovascular disease
  • Chronic kidney disease
  • Cognition
  • Depression
  • Neuropsychiatric disorders

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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