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Cognitive impairment in CKD patients: a guidance document by the CONNECT network

2024; Oxford University Press; Volume: 18; Issue: 2 Linguagem: Inglês

10.1093/ckj/sfae294

2048-8513

Davide Bolignano, Mariadelina Simeoni, Gaye Hafez, Marion Pépin, Antonio Gallo, Manuela Altieri, Sophie Liabeuf, Konstantinos Giannakou, Ananya De, Giovambattista Capasso, Giovambattista Capasso, Alexandre Andrade, Mustafa Arici, Maie Bachmann, Matthew A. Bailey, Michelangela Barbieri, Mickaël Bobot, Annette Bruchfeld, Inga Arune-Bumblyte, Daiva Rastenytė, Antonello Calcutta, Giovanna Capolongo, Sol Carriazo, Michele Ceccarelli, Adrian Covic, Ananya De, Pilar Delgado, Nicole Endlich, Matthias Endres, Fabrizio Esposito, Michele Farisco, Quentin Faucher, Ana Carina Ferreira, Andreja Figurek, Denis Fouque, Casper Franssen, Ivo Fridolin, Sebastian Frische, Liliana Gârneaţă, Loreto Gesualdo, Konstantinos Giannakou, Olivier Godefroy, Aleksandra Golenia, Dimitrios Goumenos, Eugenio Gutiérrez Jiménez, Gaye Hafez, Ewout J. Hoorn, Pedro Henrique Imenez Silva, Raafiah Izhar, Dearbhla Kelly, Shelli R. Kesler, Aleksandra Klimkowicz‐Mrowiec, Samuel Knauß, Justina Kurganaite, Hélène Levassort, Sophie Liabeuf, Jolanta Małyszko, Laila-Yasmin Mani, Gianvito Martino, Ziad A. Massy, Christopher Mayer, Armida Mucci, Alma Mutevelić-Turković, Rikke Nielsen, Dorothea Nitsch, Alberto Ortíz, Vasileios Panagiotopoulos, Despoina Karasavvidou, Giuseppe Paolisso, Bojana Pejušković, Marion Pépin, Alessandra F. Perna, Andrea Perrottelli, Vesna Pešić, Pasquale Pezzella, Merita Rroji, Ivan Rychlík, Giorgos K. Sakkas, Mariadelina Simeoni, María José Soler Romeo, Goce Spasovski, Ana Starčević, Gioacchino Tedeschi, Francesco Trevisani, Robert J. Unwin, Evgueniy Vazelov, Carsten A. Wagner, Franca Wagner, Christoph Wanner, Andrzej Więcek, Hong Xu, Miriam Zacchia, Lefteris Zacharia, Irene Zecchino, Carmine Zoccali, Francesco Mattace‐Raso, Karlhans Endlich, Norberto Perico, Giuseppe Remuzzi, Francesco Trepiccione, Mark D. Okusa, Vincenzo Di Marzo, Peter J. Blankestijn, Kai‐Uwe Eckardt, Maximilian König, Ron T. Gansevoort, Hassan Askari, Brian Bekker Hansen, Sunna Snaedal, Elena Cuiban, Edoardo Caporusso, Vincenzina Lo Re, Jonathan P. Roiser, Kerry Rosenberg, Alvino Bisecco, Laura Denby, Onkar Prakash Kulkarni, Kumar Sharma, Subrata Debnath, Afaf Jaafar, Anna Capasso, Michele M. Mulholland, Biruh Workeneh, Anna Iervolino, Simon Fraser, Isabelle Frey‐Wagner, Annachiara Pastore, Romaldas Mačiulaitis, Antonio De Donato, Ana Farinha,

Electrolyte and hormonal disorders

Abstract Cognitive impairment (CI) is a prevalent and debilitating complication in patients with chronic kidney disease (CKD). This position paper, developed by the CONNECT network, provides guidance on the epidemiology, risk factors, pathophysiology, diagnosis, and clinical management of CKD-related CI. CI is significantly more common in CKD patients compared to the general population, particularly those undergoing haemodialysis. The development of CI is influenced by a complex interplay of factors, including uremic neurotoxins, electrolytes and acid base disorders, anaemia, vascular damage, metabolic disturbances and comorbidities like diabetes and hypertension. Effective screening and diagnostic strategies are essential for early identification of CI, utilizing cognitive assessment tools, neuroimaging, and circulating biomarkers. The impact of various drug classes, including antiplatelet therapy, oral anticoagulants, lipid-lowering treatments, and antihypertensive drugs, on cognitive function is evaluated. Management strategies encompass pharmacological and non-pharmacological interventions, with recommendations for optimizing cognitive function while managing CKD-related complications. This guidance highlights the importance of addressing CI in CKD patients through early detection, careful medication management, and tailored therapeutic strategies to improve patient outcomes.