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Brazilian Journal of Nephrology

Print version ISSN 0101-2800On-line version ISSN 2175-8239

Abstract

FRANCO, Álvaro de Oliveira; STAROSTA, Rodrigo Tzovenos  and  RORIZ-CRUZ, Matheus. The specific impact of uremic toxins upon cognitive domains: a review. J. Bras. Nefrol. [online]. In press. , pp.-.  Epub Aug 09, 2018. ISSN 0101-2800.  http://dx.doi.org/10.1590/2175-8239-jbn-2018-0033.

One of the mechanisms proposed for chronic kidney disease (CKD)-related cognitive impairment is the accumulation of uremic toxins due to the deterioration of the renal clearance function. Cognition can be categorized into five major domains according to its information processing functions: memory, attention, language, visual-spatial, and executive. We performed a review using the terms 'uric acid', 'indoxyl sulfate', 'p-cresyl sulfate', 'homocysteine', 'interleukins' and 'parathyroid hormone'. These are the compounds that were found to be strongly associated with cognitive impairment in CKD in the literature. The 26 selected articles point towards an association between higher levels of uric acid, homocysteine, and interleukin 6 with lower cognitive performance in executive, attentional, and memory domains. We also reviewed the hemodialysis effects on cognition. Hemodialysis seems to contribute to an amelioration of CKD-related encephalopathic dysfunction, although this improvement occurs more in some cognitive domains than in others.

Keywords : Uremia; Cognitive Dysfunction; Knowledge; Renal Insufficiency, Chronic; Renal Dialysis; Toxins, Biological; Memory; Executive Function; Attention.

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