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Mechanisms of Cerebral Microvascular Disease in Chronic Kidney Disease.

Authors
  • Fisher, Mark1
  • 1 Department of Neurology, UC Irvine School of Medicine, 101 The City Drive South, Shanbrom Hall, Room 121, Orange, CA 92868, United States. Electronic address: [email protected] , (United States)
Type
Published Article
Journal
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
Publication Date
Sep 01, 2021
Volume
30
Issue
9
Pages
105404–105404
Identifiers
DOI: 10.1016/j.jstrokecerebrovasdis.2020.105404
PMID: 33272863
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Numerous studies report linkage between chronic kidney disease (CKD) and cerebrovascular disease. This association has been particularly strong for cerebral small vessel disease. Significant findings have emerged from studies ranging from case reports, small case series, and larger cohort investigations. The latter show a relationship between declining renal function, microvascular disease, and cognitive impairment. One troubling aspect has been the relative paucity of mechanistic investigations addressing the CKD-cerebrovascular disease linkage. Nevertheless, mechanistic observations have begun to emerge, showing cerebral microhemorrhage development in animal models of CKD independent of hypertension, an important co-morbidity in clinical studies. Initial cell culture studies show endothelial monolayer disruption by CKD serum, consistent with blood-brain barrier injury. It is noteworthy that CKD serum is known to contain multiple plausible mediators of microvascular injury. Further studies are on the horizon to address the critical question of potential linkage of renal dysfunction with vascular cognitive impairment. Copyright © 2020 Elsevier Inc. All rights reserved.

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