Chronic kidney disease and neurological disorders: are uraemic toxins the missing piece of the puzzle?

Sophie Liabeuf (1) , Marion Pepin (2, 3) , Casper Franssen (4) , Davide Viggiano , Sol Carriazo , Ron Gansevoort (5) , Loreto Gesualdo (6) , Gaye Hafez , Jolanta Malyszko , Christopher Mayer , Dorothea Nitsch , Alberto Ortiz , Vesna Pešić , Andrzej Wiecek , Ziad Massy (7) , Giovambattista Capasso , Alexandre Andrade , Maie Bachmann , Inga Bumblyte , Adrian Constantin Covic , Pilar Delgado , Nicole Endlich , Andreas Engvig , Denis Fouque , Sebastian Frische , Liliana Garneata , Konstantinos Giannakou , Dimitrios Goumenos , Ayşe Tuğba Kartal , Laila-Yasmin Mani , Hans-Peter Marti , Rikke Nielsen , Merita Rroji , Giorgos Sakkas , Goce Spasovski , Kate Stevens , Evgueniy Vazelov , Lefteris Zacharia , Ana Carina Ferreira , Ewout Hoorn , Andreja Figurek , Robert Unwin , Carsten Wagner , Christoph Wanner , Annette Bruchfeld , Ivo Fridolin , Maria José Soler Romeo , Michelangela Barbieri , Bojan Batinić , Laura Carrasco , Gianvito Martino , Francesco Mattace Raso , Ionut Nistor , Giuseppe Paolisso , Daiva Rastenytė , Gabriel Stefan , Gioacchino Tedeschi , Boris Bikbov , Karl Hans Endlich , Olivier Godefroy (8, 9) , Jean-Marc Chillon (9, 1) , Anastassia Kossioni , Justina Kurganaite , Norberto Perico , Giuseppe Remuzzi , Tomasz Grodzicki , Francesco Trepiccione , Carmine Zoccali , Mustafa Arici , Peter Blankestijn , Kai-Uwe Eckardt , Danilo Fliser , Eugenio Gutiérrez Jiménez , Maximilian Konig , Ivan Rychlik , Michela Deleidi , George Reusz

1 MP3CV - Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517
2 Hôpital Ambroise Paré [AP-HP]
3 CESPA - Centre d'épidémiologie et de santé publique des armées [Marseille]
4 Groningen University Medical Centre
5 Department of Nephrology [Groningue, Pays-Bas]
6 CeRTA
7 CESP - Centre de recherche en épidémiologie et santé des populations
8 LNFP - Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559
9 CHU Amiens-Picardie

Abstract Chronic kidney disease (CKD) perturbs the crosstalk with others organs, with the interaction between the kidneys and the heart having been studied most intensively. However, a growing body of data indicates that there is an association between kidney dysfunction and disorders of the central nervous system. In epidemiological studies, CKD is associated with a high prevalence of neurological complications, such as cerebrovascular disorders, movement disorders, cognitive impairment and depression. Along with traditional cardiovascular risk factors (such as diabetes, inflammation, hypertension and dyslipidaemia), non-traditional risk factors related to kidney damage (such as uraemic toxins) may predispose patients with CKD to neurological disorders. There is increasing evidence to show that uraemic toxins, for example indoxyl sulphate, have a neurotoxic effect. A better understanding of factors responsible for the elevated prevalence of neurological disorders among patients with CKD might facilitate the development of novel treatments. Here, we review (i) the potential clinical impact of CKD on cerebrovascular and neurological complications, (ii) the mechanisms underlying the uraemic toxins’ putative action (based on pre-clinical and clinical research) and (iii) the potential impact of these findings on patient care.

Domaines: Pharmacologie; Santé publique et épidémiologie

Sophie Liabeuf, Marion Pepin, Casper Franssen, Davide Viggiano, Sol Carriazo, et al.. Chronic kidney disease and neurological disorders: are uraemic toxins the missing piece of the puzzle?. Nephrology Dialysis Transplantation, 2021, ⟨10.1093/ndt/gfab223⟩. ⟨hal-03451534⟩