Chronic kidney disease (CKD) is a long-term condition where the kidneys slowly lose their ability to function.
While it mostly affects the body, it can also have serious effects on the brain. Many people with CKD experience memory problems, trouble thinking clearly, and a higher risk of dementia.
These brain-related issues are called cognitive impairments, and they can make life much harder for people already dealing with kidney problems.
Doctors have known that a kidney transplant often helps improve thinking and memory in people with CKD. This suggests that the brain problems might not be permanent and can be treated. But until now, scientists didn’t fully understand why CKD causes damage to the brain in the first place.
A new study from the University of Leipzig Medical Center in Germany may help answer this question. Their research focused on microglia—special immune cells that live in the brain. These cells help protect the brain and support nerve cells, but they can also cause harm when they become overactive, especially during inflammation.
The scientists discovered that CKD activates these microglial cells in a way that harms the brain. This activation causes problems with potassium balance in nerve cells, which is important for healthy brain function. Potassium helps nerve cells send signals, and when this balance is off, it can lead to problems with memory and thinking.
To study this, the team used mice and removed most of their kidney tissue to mimic CKD. The mice with kidney disease did worse on memory tests and showed lower potassium activity in the brain.
When the scientists looked closer, they found that genes related to brain diseases like Alzheimer’s, Huntington’s, and Parkinson’s were also affected. This shows that CKD might cause similar brain changes as those found in major neurological diseases.
The researchers also found that CKD damages the barrier that normally protects the brain from harmful substances in the blood. This barrier is called the blood-brain barrier. When it becomes leaky, toxins can enter the brain and cause inflammation. This further harms the brain and disturbs the balance of potassium in microglial cells.
The good news is that the scientists were able to fix this problem in their experiments. They used a drug that blocks a specific receptor in nerve cells. This drug helped restore the potassium balance and improved the thinking ability of the mice.
According to Professor Berend Isermann, one of the study’s lead researchers, this discovery points to a new way of treating cognitive problems in people with CKD. By focusing on how potassium is managed in the brain, it might be possible to reduce or even prevent memory and thinking issues.
Dr. Silke Zimmermann, another lead researcher, says the study offers hope for developing new treatments. She believes that finding better ways to manage potassium in brain cells and keeping nerve function stable could lead to real solutions for patients.
The team also hopes to find new biomarkers—signals in the body that could show early signs of brain problems in kidney disease. This would allow doctors to catch and treat the problem sooner.
In summary, this study shows how CKD can damage the brain by affecting immune cells and potassium balance. It also shows that with the right treatment, these effects might be reversed. This opens the door to new therapies that could help people with CKD live better, healthier lives.
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The study is published in Kidney International.
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