The association of cognition with protein energy wasting and synaptic transmission in chronic kidney disease.

IF 1.4 4区 医学 Q3 UROLOGY & NEPHROLOGY
Seminars in Dialysis Pub Date : 2023-07-01 Epub Date: 2023-03-02 DOI:10.1111/sdi.13146
Xia Yang, Yujun Quan, Erzhong Wu, Yuecheng Jiang, Qian Song, Yue Li, Qian Li, Zhaolin Sun, Jing Yuan, Yan Zha, Xiaoli Cui
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引用次数: 0

Abstract

Introduction: In recent years, consciousness impairment in patients with end-stage renal disease (ESRD) has been paid more and more attention, but the cause and mechanism of consciousness state change is not clear.

Methods: As the hippocampus played a crucial role in consciousness, we explored the pathological and electrophysiological changes in chronic kidney disease (CKD) mouse hippocampus.

Results: Whole-cell recordings in hippocampal neurons showed that miniature excitatory postsynaptic current (mEPSC) frequency decreased, but the amplitude was unaltered in CKD_8w mice. In addition, α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid receptor-mediated EPSCs (AMPAR-EPSCs) and N-methyl-D-aspartic acid receptor-mediated EPSCs (NMDAR-EPSCs) in hippocampal Schaffer collateral-CA1 synapses displayed a significant decline in CKD_8w mice. Although the ratio of AMPAR-/NMDAR-EPSCs did not change, the paired-pulse ratio (PPR) in CKD_8w mice increased. Intriguingly, the mEPSC frequency and AMPAR-/NMDAR-EPSCs amplitudes were positively associated with body weight, and the mEPSC frequency was negatively correlated with serum creatinine in CKD_8w mice, indicating a potential correlation between cognition and nutritional status in patients with CKD. To confirm the above hypothesis, we collected the clinical data from multiple hemodialysis centers to analyze the correlation between cognition and nutritional status.

Conclusion: Our analysis indicated that protein energy wasting (PEW) was a possible independent risk factor for consciousness dysfunction in maintenance hemodialysis (MHD) patients. Our results provided a more detailed mechanism underlying the cognitive impairment (CI) in ESRD patients at the synaptic level. Last but not least, our results showed that PEW was a probable new independent risk factor for CI in cases with ESRD.

慢性肾脏疾病认知与蛋白质能量消耗和突触传递的关系。
引言:近年来,终末期肾病(ESRD)患者的意识障碍越来越受到重视,但其意识状态变化的原因和机制尚不清楚。方法:由于海马在意识中起着至关重要的作用,我们探讨了慢性肾脏病(CKD)小鼠海马的病理和电生理变化。结果:CKD_8w小鼠海马神经元的全细胞记录显示,微小兴奋性突触后电流(mEPSC)频率降低,但振幅不变。此外,在CKD_8w小鼠中,海马Schaffer侧支-CA1突触中的α-氨基-3-羟基-5-甲基-4-异恶唑-丙酸受体介导的EPSC(AMPAR EPSC)和N-甲基-D-天冬氨酸受体介导EPSC(NMDAR EPSC)表现出显著下降。CKD_8w小鼠的AMPAR-/NMDAR-EPSCs比值没有变化,但成对脉冲比(PPR)增加。有趣的是,在CKD_8w小鼠中,mEPSC频率和AMPAR-/NMDAR-EPSCs振幅与体重呈正相关,mEPSC-频率与血清肌酐呈负相关,这表明CKD患者的认知与营养状况之间存在潜在相关性。为了证实上述假设,我们收集了多个血液透析中心的临床数据,分析了认知与营养状况之间的相关性。结论:蛋白质能量消耗(PEW)可能是维持性血液透析(MHD)患者意识功能障碍的独立危险因素。我们的研究结果在突触水平上提供了ESRD患者认知障碍(CI)的更详细的潜在机制。最后但并非最不重要的是,我们的研究结果表明,PEW可能是ESRD患者CI的一个新的独立风险因素。
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来源期刊
Seminars in Dialysis
Seminars in Dialysis 医学-泌尿学与肾脏学
CiteScore
3.00
自引率
6.20%
发文量
91
审稿时长
4-8 weeks
期刊介绍: Seminars in Dialysis is a bimonthly publication focusing exclusively on cutting-edge clinical aspects of dialysis therapy. Besides publishing papers by the most respected names in the field of dialysis, the Journal has unique useful features, all designed to keep you current: -Fellows Forum -Dialysis rounds -Editorials -Opinions -Briefly noted -Summary and Comment -Guest Edited Issues -Special Articles Virtually everything you read in Seminars in Dialysis is written or solicited by the editors after choosing the most effective of nine different editorial styles and formats. They know that facts, speculations, ''how-to-do-it'' information, opinions, and news reports all play important roles in your education and the patient care you provide. Alternate issues of the journal are guest edited and focus on a single clinical topic in dialysis.
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