@article{
author = "Liabeuf, Sophie and Pešić, Vesna and Spasovski, Goce and Maciulaitis, Romaldas and Bobot, Mickaël and Farinha, Ana and Wagner, Carsten A. and Unwin, Robert J. and Capasso, Giovambattista and Bumblyte, Inga Arune and Hafez, Gaye",
year = "2023",
abstract = "People living with chronic kidney disease (CKD) frequently suffer from mild cognitive impairment and/or other
neurocognitive disorders. This review in two parts will focus on adverse drug reactions resulting in cognitive impairment
as a potentially modifiable risk factor in CKD patients. Many patients with CKD have a substantial burden of
comorbidities leading to polypharmacy. A recent study found that patients seen by nephrologists were the most complex
to treat because of their high number of comorbidities and medications. Due to polypharmacy, these patients may
experience a wide range of adverse drug reactions. Along with CKD progression, the accumulation of uremic toxins may
lead to blood–brain barrier (BBB) disruption and pharmacokinetic alterations, increasing the risk of adverse reactions
affecting the central nervous system (CNS). In patients on dialysis, the excretion of drugs that depend on kidney
function is severely reduced such that adverse and toxic levels of a drug or its metabolites may be reached at relatively
low doses, unless dosing is adjusted. This first review will discuss how CKD represents a risk factor for adverse drug
reactions affecting the CNS via (i) BBB disruption associated with CKD and (ii) the impact of reduced kidney function and
dialysis itself on drug pharmacokinetics.",
publisher = "Oxford University Press ( Oxford Academic)",
journal = "Clinical Kidney Journal",
title = "Drugs with a negative impact on cognitive function (Part 1): chronic kidney disease as a risk factor",
volume = "0",
number = "0",
pages = "1-13",
doi = "10.1093/ckj/sfad241"
}