J Neurocrit Care.  2017 Jun;10(1):13-18. 10.18700/jnc.170008.

Neurocritical Care for Patients with Kidney Dysfunction

• Park I

• KMID: 2385881
• DOI: http://doi.org/10.18700/jnc.170008

Abstract

Kidney impairment due to acute kidney injury or chronic kidney disease is a potent risk factor for stroke which is a leading cause of morbidity and mortality worldwide. Patients with kidney impairment have various neurologic complications, including uremic encephalopathy, polyneuropathy, and cognitive impairment as well as higher rates of ischemic and hemorrhagic stroke and frequent seizures. Due to hypertension, coagulopathy, platelet dysfunction, and vascular disease, patients with kidney impairment are at high risk for types of catastrophic intracranial hemorrhages and strokes that typically lead to intracranial hypertension and cerebral herniation syndrome. Kidney impairment can alter drug pharmacokinetics and pharmacodynamics, and consequently patients with kidney impairment are at risk of experiencing adverse effects. Several central nervous system imaging modalities are not recommended in patients with compromised kidney function. Therefore, management of acute neurological conditions requires special attention in patients with kidney impairment. Given these common acute neurological conditions, physicians who care for patients with kidney impairment must be aware of evaluation and treatment of neurological diseases to achieve positive neurological outcomes.

Keyword

Cerebrovascular disorders; Kidney diseases; Intracranial hypertension; Seizures

MeSH Terms

Acute Kidney Injury
Blood Platelets
Brain Diseases
Central Nervous System
Cerebrovascular Disorders
Cognition Disorders
Humans
Hypertension
Intracranial Hemorrhages
Intracranial Hypertension
Kidney Diseases
Kidney*
Mortality
Pharmacokinetics
Polyneuropathies
Renal Insufficiency, Chronic
Risk Factors
Seizures
Stroke
Vascular Diseases

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