Care pathways for patients with cognitive impairment and chronic kidney disease

作者：Marion Pépin, Konstantinos Giannakou, Hélène Levassort, Ana Farinha, Mickaël Bobot, Vincenzina Lo Re, Aleksandra Golenia, Jolanta Małyszko, Francesco Mattace‐Raso, Aleksandra Klimkowcz-Mrowiec, Liliana Gârneaţă, Evgueniy Vazelov, Elena Stepan, Giovanna Capolongo, Ziad A. Massy, Andrzej Więcek, CONNECT Action (Cognitive Decline in Nephro-Neurology European Cooperative Target) collaborators, Giovambattista Capasso, Alexandre Andrade, Mustafa Arici, Maie Bachmann, Matthew A. Bailey, Michelangela Barbieri, Mickaël Bobot, Annette Bruchfeld, Inga Arune-Bumblyte, Daiva Rastenytė, Antonello Calcutta, Giovanna Capolongo, Sol Carriazo, Michele Ceccarelli, Adrian Covic, Ananya De, Pilar Delgado, Nicole Endlich, Matthias Endres, Fabrizio Esposito, Michele Farisco, Quentin Faucher, Ana Carina Ferreira, Andreja Figurek, Denis Fouque, Casper Franssen, Ivo Fridolin, Sebastian Frische, Liliana Gârneaţă, Loreto Gesualdo, Konstantinos Giannakou, Olivier Godefroy, Aleksandra Golenia, Dimitrios Goumenos, Eugenio Gutiérrez Jiménez, Gaye Hafez, Ewout J. Hoorn, Pedro Henrique Imenez Silva, Raafiah Izhar, Dearbhla Kelly, Shelli R. Kesler, Aleksandra Klimkowicz‐Mrowiec, Samuel Knauß, Justina Kurganaite, Hélène Levassort, Sophie Liabeuf, Jolanta Małyszko, Laila‐Yasmin Mani, Gianvito Martino, Ziad A. Massy, Christopher Mayer, Armida Mucci, Alma Mutevelić-Turković, Rikke Nielsen, Dorothea Nitsch, Alberto Ortíz, Vasileios Panagiotopoulos, Despoina Karasavvidou, Giuseppe Paolisso, Bojana Pejušković, Marion Pépin, Alessandra Perna, Andrea Perrottelli, Vesna Pešić, Pasquale Pezzella, Merita Rroji, Ivan Rychlík, Giorgos K. Sakkas, Mariadelina Simeoni, María José Soler Romeo, Goce Spasovski, Ana Starčević, Gioacchino Tedeschi, Francesco Trevisani, Robert J. Unwin, Evgueniy Vazelov, Carsten A. Wagner, Franca Wagner, Christoph Wanner, Andrzej Wiecek, Hong Xu, Miriam Zacchia, Lefteris Zacharia, Irene Zecchino, Carmine Zoccali, Francesco Mattace‐Raso, Karlhans Endlich, Norberto Perico, Giuseppe Remuzzi, Francesco Trepiccione, Mark Okusa, Vincenzo Di Marzo, Peter J. Blankestijn, Kai‐Uwe Eckardt, Maximilian König, Ron T. Gansevoort, Hassan Askari, Brian Bekker Hansen, Sunna Snaedal, Elena Cuiban, Edoardo Caporusso, Vincenzina Lo Re, Jonathan P. Roiser, Kerry Rosenberg, Alvino Bisecco, Laura Denby, Onkar Prakash Kulkarni, Kumar Sharma, Subrata Debnath, Afaf Jaafar, Anna Capasso, Michele M. Mulholland, Biruh Workeneh, Anna Iervolino, Simon Fraser, Isabelle Frey‐Wagner, Annachiara Pastore, Romaldas Mačiulaitis, Antonio De Donato, Ana Farinha · 发表于：Nephrology Dialysis Transplantation · 年份：2025 · DOI：10.1093/ndt/gfae264 · 被引用次数：8 · 研究领域：Dialysis and Renal Disease Management、Chronic Kidney Disease and Diabetes、Dementia and Cognitive Impairment Research

Various epidemiological datasets and pathophysiological hypotheses have highlighted a significant link between chronic kidney disease (CKD) and cognitive impairment (CI); each condition can potentially exacerbate the other. Here, we review the mutual consequences of CKD and CI on health outcomes and care pathways and highlight the complexities due to the involvement of different specialists. Our narrative review covers (i) the burden of CI among patients with CKD, (ii) the impact of CI on kidney health, (iii) access to kidney replacement therapy for people with CI, (iv) resources in cognitive care and (v) potential models for integrated 'nephro-cognitive' care. CI (ranging from mild CI to dementia) has a significant impact on older adults, with a high prevalence and a strong association with CKD. Furthermore, CI complicates the management of CKD and leads to a higher mortality rate, poorer quality of life and higher healthcare costs. Due to difficulties in symptom description and poor adherence to medical guidelines, the presence of CI can delay the treatment of CKD. Access to care for patients with both CKD and CI is hindered by physical, cognitive and systemic barriers, resulting in less intensive, less timely care. Multidisciplinary approaches involving nephrologists, geriatricians, neurologists and other specialists are crucial. Integrated care models focused on person-centred approaches, shared decision-making and continuous co-management may improve outcomes. Future res...