Cognitive Impairment in Chronic Kidney Disease-Prevalence, Mechanisms and Consequences

In ageing populations, chronic kidney disease (CKD) gets an increasing health problem worldwide. While current therapy of CKD mostly focusses on kidney function and cardiovascular comorbidity, cognition, which crucially influences adherence to CKD therapy, is often neglected. Prevalence of cognitive impairment is high in CKD, ranging from 17% to 87%, depending on CKD severity and cognitive domain affected. In contrast to Alzheimer’s disease patients, which often show impairment in memory function, CKD patients present with a broader spectrum of cognitive deficits, namely impairment in executive function, information processing, language and visuoconstruction which is usually mild in early CKD stages but advances with CKD progression and progression of comorbidities. Mechanisms underlying cognitive impairment in CKD are discussed and conclusions are derived how cognitive impairment may be prevented in CKD and, if cognitive deficits are present, how cognitive impairment may be taken into consideration in patient management.