Amelioration of ischemic brain damage by peritoneal dialysis

Godino, María del Carmen; Romera, Víctor G.; Sánchez-Tomero, José Antonio; Pacheco, Jesús; Canals, Santiago; Lerma, Juan; Vivancos, José; Moro, Marı́a A.; Torres, Magdalena; Lizasoaín, Ignacio; Sánchez‐Prieto, José

doi:10.1172/jci67284

Cited by 49 publications

(36 citation statements)

References 31 publications

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“…The deleterious effect of glutamate has been well documented in human stroke and in animal models of cerebral ischemia. In agreement with this, experimental studies from our research group have shown the beneficial effect on stroke outcome of glutamate uptake, mediated by glutamate transporters (Hurtado et al, 2008;Mallolas et al, 2006), or by its clearance using peritoneal dialysis (Godino et al, 2013).…”

Section: Glutamate Release and Microglia Activationsupporting

confidence: 76%

The Complexity of the Innate Immune System Activation in Stroke Pathogenesis

et al. 2015

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Section: Glutamate Release and Microglia Activationsupporting

confidence: 76%

The Complexity of the Innate Immune System Activation in Stroke Pathogenesis

et al. 2015

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“…Severe renal impairment has certainly been linked to brain insults. Renal insufficiency may lead to an increase in serum glutamate and other excitotoxic substances in the blood [33] or intracranial hemorrhage following thrombolytic treatment for stroke [34]. We do not have cognitive outcomes in our study and we therefore cannot assess whether ACR or WMH are better predictors of cognitive decline.…”

Section: Discussionmentioning

confidence: 99%

Urinary Albumin to Creatinine Ratio as Potential Biomarker for Cerebral Microvascular Disease

Strickland¹,

Rossetti²,

Peshock³

et al. 2014

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Elevated urinary albumin to creatinine ratio (ACR) and white matter hyperintensity (WMH) volume seen on brain MRI are measures of microvascular disease which may have shared susceptibility to metabolic and vascular insults. We hypothesized that elevated ACR may be useful as inexpensive biomarker to predict presence of cerebral microvascular disease. We assessed the association between ACR at study entry and subsequent WMH volume. We evaluated pulse pressure, mean arterial pressure, hypertension duration, waist circumference, fasting glucose, glomerular filtration rate (GFR) and C-reactive protein (CRP) as potential mediators and diabetes as a moderator of the association between ACR and WMH. Data were collected at study entry and at follow-up approximately 7 years later in a multi-ethnic population sample of 1281 participants (mean age=51, SD=9.5) from Dallas County. Overall, ACR differences were only marginally (p= 0.05) associated with subsequent WMH. In mediator analysis, however, ACR differences related specifically to arterial pulsatility(β=0.010, bootstrap 95% Confidence Interval (CI): 0.002 to 0.021) and waist circumference (β= -0.004, bootstrap 95% CI: -0.011 to -0.001) were significantly associated with WMH. ACR differences related to serum glucose and CRP were not associated with WMH. ACR evaluated at the same time as WMH had a higher level of significance (p< 0.001) indicating greater utility in predicting current cerebrovascular insults.

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“…55 Peritoneal dialysis is effective in removing glutamate, 55 and experimental evidence from animal models indicates that removal of glutamate by peritoneal dialysis can reduce infarct size and restore functional brain tissue. 56 …”

Section: Stroke In Patients Undergoing Haemodialysismentioning

confidence: 99%

Kidney–brain crosstalk in the acute and chronic setting

et al. 2015

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Patients with kidney disease often exhibit multiple organ dysfunction that is caused, in part, by marked connectivity between the kidney and other organs and tissues. Substantial crosstalk occurs between the kidney and the brain, as indicated by the frequent presentation of neurological disorders, such as cerebrovascular disease, cognitive impairment, and neuropathy during the natural history of chronic kidney disease. The underlying pathophysiology of such comorbid neurological disorders in kidney disease is governed by shared anatomic and vasoregulatory systems and humoral and non-humoral bidirectional pathways that affect both the kidney and the brain. During acute kidney injury, the brain and kidney might interact through the amplification of cytokine-induced damage, extravasation of leukocytes, oxidative stress, and dysregulation of sodium, potassium, and water channels. The advent of dialysis and renal transplantation programmes has led to a reduction in the rate of neurological complications associated with uraemia, but a new set of complications have arisen as a consequence of the effects of dialysis on the central nervous system over the short and long term. This Review discusses the clinical complications of acute and chronic renal failure from a neurologic perspective, and highlights current understanding of the underlying pathophysiologies.

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Amelioration of ischemic brain damage by peritoneal dialysis

Cited by 49 publications

References 31 publications

The Complexity of the Innate Immune System Activation in Stroke Pathogenesis

The Complexity of the Innate Immune System Activation in Stroke Pathogenesis

Urinary Albumin to Creatinine Ratio as Potential Biomarker for Cerebral Microvascular Disease

Kidney–brain crosstalk in the acute and chronic setting

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