Minorities Have A Higher Risk
Hispanic and African-American dialysis patients were found to have about twice the risk of being diagnosed with dementia and Alzheimers disease compared to whites.
According to Szerlip, Blacks and Hispanics also develop CKD at a higher rate than whites, possibly because they experience more obesity, more diabetes, and less access to healthcare.
Our study was not able to tease apart why blacks, Hispanics, or women on dialysis were more likely to be diagnosed with dementia, added DeMarco.
Skip The Protein Powders
In 2020, the Kidney Disease Outcomes Quality Initiative from the National Kidney Foundation recommended that those with kidney disease not follow a high protein diet. In later stages of kidney disease , protein recommendations can be as low as 0.4 grams per kilogram of body weight.
When it comes to safely adding calories, do not add protein powders if you have kidney disease. This may prevent weight loss but will do your kidneys no favors.
Feeling Faint Dizzy Or Weak
Why this happens:
Anemia related to kidney failure means that your brain is not getting enough oxygen. This can lead to feeling faint, dizzy, or weak.
What patients said:
I was always tired and dizzy.
It got to the point, like, I used to be at work, and all of the sudden I’d start getting dizzy. So I was thinking maybe it was my blood pressure or else diabetes was going bad. That’s what was on my mind.
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Dementia Due To Metabolic Causes
Dementia is loss of brain function that occurs with certain diseases.
Dementia due to metabolic causes is a loss of brain function that can occur with abnormal chemical processes in the body. With some of these disorders, if treated early, brain dysfunction can be reversible. Left untreated, permanent brain damage, such as dementia, can occur.
When To Get Medical Advice
See your GP if you have persistent or worrying symptoms that you think could be caused by kidney disease.
The symptoms of kidney disease can be caused by many less serious conditions, so it’s important to get a proper diagnosis.
If you do have CKD, it’s best to get it diagnosed as soon as possible. Kidney disease can be diagnosed by having blood and urine tests.
Find out more about how CKD is diagnosed.
Page last reviewed: 29 August 2019 Next review due: 29 August 2022
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Fluid Weight Loss With Kidney Disease
Its important to know that weight loss or weight gain and kidney disease may be connected due to fluid balance.
The kidneys are responsible for making urine and controlling blood pressure. The amount of urine you make or dont make is dependent on your kidney function, salt intake, and fluid balance.
Symptoms Of Memory Loss
Symptoms of memory loss could include:
- Not being able to recall an important event in your life
- Forgetting what you have just done
- Forgetting where things in your home are
- Forgetting the names of people close to you
Some of these can happen to all of us from time to time, but if they start to occur more often than normal and cause you problems, it could be a sign of a more serious problem.
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Healthy Weight Loss With Kidney Disease
For those with a overweight or obese body mass index , your doctor may encourage some weight loss to help manage your health conditions including kidney disease.
Healthy weight loss is generally seen as weight loss of one to two pounds per week. For those with over 100 pounds of weight to lose, aiming for approximately 1% weight loss per week may be acceptable.
An overall weight loss goal that can still show benefits can be anywhere from 5-10% of your current weight over the course of 6 months.
Benefits of kidney disease and weight loss
Other benefits that have been found with weight loss for kidney disease includeless protein in the urine and lower systolic blood pressure.
How Can Diabetes Affect Memory Loss
Memory loss in diabetes can be a short term problem brought on by too low or high blood glucose levels.
During hypoglycemia , for example, you may struggle to remember words. This is not necessarily a sign of a long term problem. In most cases, raising sugar levels over 4 mmol/l should get your memory back to normal.
If memory problems happen at other times and this significantly affects your life, speak to your GP.
Diabetes can increase the risk of developing long-term memory problems if blood glucose levels are less well controlled. High blood glucose levels , over a number of years, can damage the nerves, including those of the brain, which can increase the risk of dementia
Research shows that good diabetes management can help prevent memory problems from developing or advancing.
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Swollen Or Puffy Face
Why this happens:
Failing kidneys don’t remove extra fluid, which builds up in your body causing swelling in the face.
What patients said:
My sister, her hair started to fall out, she was losing weight, but her face was really puffy, you know, and everything like that, before she found out what was going on with her.
My checks were always puffy and tight. Sometimes they would even hurt.
Open Questions And Opportunities For Mci
Although the first description of uraemic encephalopathy was published some 80years ago, our understanding of brain dysfunction in CKD, prevention and treatment is still in its infancy. The pathogenesis MCI-CKD remains in the realm of hypothesis and its specificity when compared with MCI-GP is based on limited data. Nevertheless, the problem has gained increasing attention among nephrologists as shown by a rapidly increasing number of publications describing neurological and psychological changes in CKD patients: the number of published papers containing the keywords CKD and brain was only 130 up to the year 2012, whereas in the years 201318 they are 328 .
The main advance in our understanding of this syndrome in the last 80years has been more of a change in terminology, from uraemic encephalopathy to MCI-CKD. While this suggests a growing recognition of the problem of MCI, it also risks failing to take full account of earlier data and published findings.
We will try to summarize what we believe are the main open questions worth addressing with the aid of newer technologies:
Does the distinction between MCI-GP and MCI-CKD really exist or does MCI-CKD only represent an extreme or accelerated phenotype of MCI-GP?
What is the contribution of accelerated aging and conventional cardiovascular risk factors to MCI-CKD?
Do we have firm criteria for the diagnosis of MCI-CKD?
What is the natural history of MCI-CKD?
Can MCI-CKD be treated, prevented or even reversed?
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How To Utilize Team Care
Neurologist consultation should be considered when the diagnosis and etiology of cognitive impairment is in doubt. The neurologist may also assess in developing an appropriate plan of care. In addition, referral for neuropsychological testing may help to define the specific neurocognitive deficits. Many of the patients with CKD will be co-managed with primary care physicians who will help to set goals of care and long-term planning. Lastly, a psychiatric referral would be reasonable when there is a question of whether the patient has underlying depression or depression refractory to treatment.
Nurses play a key role in the recognition and multi-disciplinary managent of cognitive impairment in patients with chronic health conditions. Nurses may also play a supportive role for caregivers and provide resourses to family members.
Given the polypharmacy of patients with chronic kidney disease, pharmacists may play an important role in the multidisciplinary care of the CKD patient with cognitive impairment.
Mechanisms Relating Kidney Disease To Cognition
Table 6 lists variables that may mediate between renal disease and cognitive function. One may hypothesize, among other models, direct paths in which CKD affects brain function and morphology and hence cognition. An alternative, and not mutually exclusive, possibility is that risk factors shared by brain and kidney lead to cognitive deficit, decline and impairment . This parallel risk factor model is appealing because both kidney and brain are low resistance end organs and are exposed and re-exposed to high-volume blood flow though the cardiac cycle’ , p. 5]. Thus the brain and kidney very likely share common risk factors for cognitive deficit and impairment. It is clear that the issue of mediating variables becomes complex once treatment is initiated for ESRD. Thus we refer the reader to a comprehensive model by Murray and Knopman and in table 6 summarize the many candidate mechanisms. In pretreatment forms of renal disease it makes some sense that the search for mechanisms should begin with the strongest risk factors for kidney disease, i.e. hypertension and diabetes. However, few if any mediation studies have been undertaken.
Table 6
Some candidate mechanisms mediating between kidney disease and cognitive functioning on order of discussion in text1
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Hearing Loss Related Complications
If your ears cannot pick up sounds, your hearing nerves will send only fewer signals to your brain, and thus depriving your brain of stimulation, it once had. When you are trying hard to listen, your brain may go through cognitive overload. This means that when your brain is working hard to decode what others are saying, it doesnt store the information in your memory as well as if you are listening with ease. This is one way that hearing loss can affect memory and contribute to a quicker decline in thinking.
Here are a few hearing loss-related complications:
Nature Of Cognitive Impairment
In recent years, several clinical studies have concentrated on the burden of MCI in CKD patients . Among patients with CKD, the prevalence of MCI has been estimated to be as high as 30% to 63% , which is approximately twice as high as in the age-matched general population. The stage of CKD is apparently related to the risk of MCI: the lower the estimated glomerular filtration rate the higher the risk of MCI . Notably, discernible cognitive changes may appear already in early CKD stages .
Interestingly, patients with end-stage renal disease have a similar MCI burden with or without haemodialysis, or peritoneal dialysis . This is surprising because recent data show that haemodialysis modifies cerebral blood flow as a function of ultrafiltration volume . However, after 12months, this brain haemodynamic effect correlates with a better performance with the MoCA test for MCI . This observation is also supported by the improvement of the cognitive functions after the start of dialysis, possibly with better results using peritoneal dialysis compared with haemodialysis . Therefore, the decline of cerebral blood flow observed during haemodialysis may not contribute to MCI.
This might be interpreted as the presence of toxins not eliminated by the dialysis process, or the deficit of neuroprotective substances produced by the kidney that have not been directly replaced yet.
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Alcohol Or Illicit Drugs
Drinking alcohol or using illicit drugs can impair your memory, both in the short term and long term. From blackouts to an increased risk of dementia years later, these substances can significantly harm your memory, among many other things. Too much alcohol can also cause Wernicke-Korsakoff syndrome, which if treated immediately, may be able to be partially reversed in some people.
Study Of More Than 350000 Patients Hints That End
Older kidney disease patients who are sick enough to require the blood-filtering treatment known as dialysis are at high risk of dementia, including Alzheimers disease, according to a study led by scientists at Johns Hopkins Bloomberg School of Public Health.
The study, published Aug. 9 in the Clinical Journal of the American Society for Nephrology, found evidence that older kidney disease patients had a substantially higher risk of being diagnosed with dementia than community-dwelling older adults.
The dementia risk in this population seems to be much higher than what we see among healthy community-dwelling older adults, says study lead author Mara McAdams-DeMarco, assistant professor of epidemiology at the Bloomberg School.
To McAdams-DeMarco and her colleagues, the findings suggest that doctors should be doing more to monitor, and if possible to slow or prevent, cognitive decline among older dialysis patients. The high incidence of dementia seems to be overlooked in this population, she says.
The precise biological mechanism linking kidney disease to brain problems isnt yet clear, but kidney disease has itself been linked to poor blood flow in the brain, so researchers suspect that as a key factor.
Alzheimers disease represented a significant proportion of dementia diagnoses: The one-year risk of this form of dementia was 0.6 percent for women and 0.4 percent for men.
Funding was provided by the National Institutes of Health .
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Shortness Of Breath After Very Little Effort
Why this happens:
Being short of breath can be related to the kidneys in two ways. First, extra fluid in the body can build up in the lungs. And second, anemia can leave your body oxygen-starved and short of breath.
What patients said:
At the times when I get the shortness of breath, it’s alarming to me. It just fears me. I think maybe I might fall or something so I usually go sit down for awhile.
I couldn’t sleep at night. I couldn’t catch my breath, like I was drowning or something. And, the bloating, can’t breathe, can’t walk anywhere. It was bad.
When To See A Healthcare Provider
If you’re worried you may be experiencing symptoms of an autoimmune condition, be sure to see a healthcare provider for a comprehensive evaluation, which will include a thorough physical examination, blood tests, and possibly imaging tests.
If your primary care or family healthcare provider suspects an autoimmune process, you will likely be referred to a specialist, such as a rheumatologist , an endocrinologist , or a gastroenterologist .
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What Is Chronic Kidney Disease
Chronic kidney disease, sometimes called CKD, is an umbrella term for several conditions that affect the kidneys, but it generally means permanent and usually progressive damage to the kidneys caused by a variety of conditions.
Learn Your ABCs of Kidney Disease
Johns Hopkins nephrologists Drs. Sumeska Thavarajah and Daphne Knicely offer a free educational class most months, from 5 6 p.m. at Johns Hopkins Bayview Medical Center. For more information, call .
Concussions And Head Injuries
Concussions and traumatic head injuries can cause short-term memory impairment, but some research has found that they can also increase the likelihood for the development of dementia over the years.
Be sure to take steps like wearing protective headgear and helmets when playing sports. And, if you do sustain a concussion, it’s important to let your head fully heal before returning to regular activities and participating in sports. Discuss any headaches and concentration difficulties after a head injury with your doctor.
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Neuropsychiatric Disorders In Chronic Kidney Disease
- 1Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, UFMG, Belo Horizonte, Brazil
- 2Laboratory of Neurobiology, Department of Morphology, Institute of Biological Sciences, UFMG, Houston, Brazil
- 3Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
Does This Patient Have Cognitive Dysfunction In Chronic Kidney Disease
Cognitive impairment increases in prevalence with chronic kidney disease severity, potentially affecting up to 60% of CKD patients. There may also be specific domains of cognition that are impaired for patients with CKD, such as executive cognitive function. Similar to the general population, a dementia diagnosis is more common among the elderly, women, and non-white patients with end-stage renal disease , and less common among patients receiving peritoneal dialysis and transplant recipients, possibly reflecting patient selection and ascertainment bias.
Screening and diagnosis
Cognitive impairment is defined as a new deficit in more than one of the domains of cognitive functioning, which include disturbances in memory, executive functioning, orientation, reasoning, attention, language and cognitive skills necessary for planning and sequencing tasks.Cognitive impairment in the domains of memory, attention, and executive function is common among patients with CKD and dialysis. Studies reveal that working memory and executive function, two key domains of cognitive ability, are potentially important factors in medication compliance.
Mild cognitive impairment is the term given to patients who are not normal because of deficits in more than one cognitive domain but who appear to function independently in daily functioning. Cognitive impairment without dementia is also associated with increased risk for disability, increased health care costs, and progression to dementia.
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What Happens To Patients With Cognitive Dysfunction In Chronic Kidney Disease
Cognitive impairment in CKD not only increases the risk of mortality but also has major implications for informed consent in relation to dialysis initiation and maintenance, and ultimately transplantation. In an integrated prognostic model of 6-month survival for patients with HD, dementia was significantly associated with early mortality. Moreover, cognitive impairment may decrease an individuals quality of life, increase resource utilization, increase in medical cost, and result in suboptimal medical care because of difficulty following caregivers recommendations.
However, several studies have shown that cognitive impairment in CKD patients is largely undetected and under treated by clinicians. Therefore, identifying cognitive impairment may lead to the institution of supportive care measures that improve outcomes and reduce disease burden.
Cognitive impairment can alter functioning in numerous areas of life including work, school, family, social relationships, leisure activities, or maintenance of health and hygiene. The physician should evaluate the patients activity in each of these domains and determine the presence, type, severity, and chronicity of any dysfunction.