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Disentangling the multiple links between renal dysfunction and cerebrovascular disease
Chronic kidney disease (CKD) has a rapidly rising global prevalence, affecting as many as one-third of the population over the age of 75 years. CKD is a well-known risk factor for cardiovascular disease and, in particular, there is a strong association with stroke. Cohort studies and trials indicate...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952845/ https://www.ncbi.nlm.nih.gov/pubmed/31511306 http://dx.doi.org/10.1136/jnnp-2019-320526 |
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author | Kelly, Dearbhla Rothwell, Peter Malcolm |
author_facet | Kelly, Dearbhla Rothwell, Peter Malcolm |
author_sort | Kelly, Dearbhla |
collection | PubMed |
description | Chronic kidney disease (CKD) has a rapidly rising global prevalence, affecting as many as one-third of the population over the age of 75 years. CKD is a well-known risk factor for cardiovascular disease and, in particular, there is a strong association with stroke. Cohort studies and trials indicate that reduced glomerular filtration rate increases the risk of stroke by about 40% and that proteinuria increases the risk by about 70%. In addition, CKD is also strongly associated with subclinical cerebrovascular abnormalities, vascular cognitive impairment and dementia. The mechanisms responsible for these associations are currently unclear. CKD is associated with traditional risk factors such as hypertension, diabetes mellitus and atrial fibrillation, but non-traditional risk factors such as uraemia, oxidative stress, mineral and bone abnormalities, and dialysis-related factors, such as changes in cerebral blood flow or cardiac structure, are also postulated to play a role. Kidney disease can also impact and complicate the treatments used in acute stroke and in secondary prevention. In this review, we will outline our current understanding of the epidemiology and pathophysiology of cerebrovascular disease in CKD. |
format | Online Article Text |
id | pubmed-6952845 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-69528452020-01-23 Disentangling the multiple links between renal dysfunction and cerebrovascular disease Kelly, Dearbhla Rothwell, Peter Malcolm J Neurol Neurosurg Psychiatry Cerebrovascular Disease Chronic kidney disease (CKD) has a rapidly rising global prevalence, affecting as many as one-third of the population over the age of 75 years. CKD is a well-known risk factor for cardiovascular disease and, in particular, there is a strong association with stroke. Cohort studies and trials indicate that reduced glomerular filtration rate increases the risk of stroke by about 40% and that proteinuria increases the risk by about 70%. In addition, CKD is also strongly associated with subclinical cerebrovascular abnormalities, vascular cognitive impairment and dementia. The mechanisms responsible for these associations are currently unclear. CKD is associated with traditional risk factors such as hypertension, diabetes mellitus and atrial fibrillation, but non-traditional risk factors such as uraemia, oxidative stress, mineral and bone abnormalities, and dialysis-related factors, such as changes in cerebral blood flow or cardiac structure, are also postulated to play a role. Kidney disease can also impact and complicate the treatments used in acute stroke and in secondary prevention. In this review, we will outline our current understanding of the epidemiology and pathophysiology of cerebrovascular disease in CKD. BMJ Publishing Group 2020-01 2019-09-11 /pmc/articles/PMC6952845/ /pubmed/31511306 http://dx.doi.org/10.1136/jnnp-2019-320526 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Cerebrovascular Disease Kelly, Dearbhla Rothwell, Peter Malcolm Disentangling the multiple links between renal dysfunction and cerebrovascular disease |
title | Disentangling the multiple links between renal dysfunction and cerebrovascular disease |
title_full | Disentangling the multiple links between renal dysfunction and cerebrovascular disease |
title_fullStr | Disentangling the multiple links between renal dysfunction and cerebrovascular disease |
title_full_unstemmed | Disentangling the multiple links between renal dysfunction and cerebrovascular disease |
title_short | Disentangling the multiple links between renal dysfunction and cerebrovascular disease |
title_sort | disentangling the multiple links between renal dysfunction and cerebrovascular disease |
topic | Cerebrovascular Disease |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952845/ https://www.ncbi.nlm.nih.gov/pubmed/31511306 http://dx.doi.org/10.1136/jnnp-2019-320526 |
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