Evidence map›Paper›PMID 31378643›Full record

ReviewAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2019

Cognitive Impairment in CKD: Pathophysiology, Management, and Prevention.

David A Drew, Daniel E Weiner, Mark J Sarnak

Open access · greenAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 258 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
258citing papers in PubMed, 5 pooled it
15.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

258 citing papers in PubMed, 5 syntheses or guidelines pooled it, 428 citations in OpenAlex.

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  15. Marine drugs · 2026
    Article
  16. Kidney function and brain health: cognitive and structural signatures across cohorts.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Article
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  18. Review
  19. Article
  20. Observational

198 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

David A DrewDivision of Nephrology, Department of Medicine, Tufts Medical Center, Boston, MA.
Daniel E WeinerDivision of Nephrology, Department of Medicine, Tufts Medical Center, Boston, MA.
Mark J SarnakDivision of Nephrology, Department of Medicine, Tufts Medical Center, Boston, MA. Electronic address: msarnak@tuftsmedicalcenter.org.
Tufts Medical Center · US

Funding

The association of FGF-23 and Klotho with cognitive impairment and cerebrovascular disease in chronic kidney diseaseK23DK105327 · NIDDK · TUFTS MEDICAL CENTER · PI DREW, DAVID ALAN · 2016 to 2020
$958k
NIDDK NIH HHS K23 DK105327
6 · The paper itself

Abstract

Patients with chronic kidney disease (CKD) are at substantially higher risk for developing cognitive impairment compared with the general population, and both lower glomerular filtration rate and the presence of albuminuria are associated with the development of cognitive impairment and poorer cognitive function. Given the excess of vascular disease seen in individuals with CKD, cerebrovascular disease is likely the predominant pathology underlying these associations, though impaired clearance of uremic metabolites, depression, sleep disturbance, anemia, and polypharmacy may also contribute. Modification of vascular disease risk factors may be helpful in limiting decline, though definite data are lacking. Specific to CKD, targeting a low blood pressure and reduction in albuminuria with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers may slow cognitive decline, albeit modestly. Initiation of dialysis can improve severe impairment associated with uremia but does not appear to affect more subtle chronic cognitive impairment. In contrast, kidney transplantation appears to lead to improved cognitive function in many transplant recipients, suggesting that dialysis methods do not provide the same cognitive benefits as having a functioning kidney. Management of patients with both CKD and cognitive impairment should include a comprehensive plan including more frequent follow-up visits; involvement of family in shared decision making; measures to improve compliance, such as written instruction and pill counts; and a focus on advance directives in conjunction with an emphasis on understanding an individual patient's life goals. Further research is needed on novel therapies, including innovative dialysis methods, that aim to limit the development of cognitive impairment, slow decline in those with prevalent impairment, and improve cognitive function.

Indexed as

AgedAge FactorsCognitive DysfunctionCombined Modality TherapyDisease ManagementDisease ProgressionFemaleHumansIncidenceMaleMiddle AgedNeuropsychological TestsPrognosisRenal DialysisRenal Insufficiency, ChronicSeverity of Illness Indexcerebrovascular diseaseChronic kidney disease (CKD)cognitive impairmentdementiadialysisend-stage renal disease (ESRD)reviewuremic metabolitesvascular disease

Identifiers

PMID31378643
PMCPMC7038648
OpenAlexW2965654579

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.