Brain–kidney interaction: Renal dysfunction following ischemic stroke

Abstract

Stroke is a leading cause of mortality and morbidity, with long-term debilitating effects. Accumulating evidence from experimental studies as well as observational studies in patients suggests a cross talk between the brain and kidney after stroke. Stroke may lead to kidney dysfunction which can adversely impact patient outcome. In this review article, we discuss the epidemiology and mechanisms of brain–kidney interaction following ischemic stroke. Specifically, we discuss the role of the central autonomic network, autoregulation, inflammatory and immune responses, the role of extracellular vesicles and their cargo microRNA, in mediating brain–kidney interaction following stroke. Understanding the bidirectional nature of interaction between the brain and kidney after cerebral injury would have clinical implications for the treatment of stroke and overall patient outcome.

Cardiac Dysfunction in a Mouse Vascular Dementia Model of Bilateral Common Carotid Artery Stenosis

“…Specifically, in BCAS, direct activation of angiotensin type 2 receptor was found to increase CBF and reduce inflammation, thereby improving cognitive function in mice (32). RAAS plays an important role in CBF regulatory mechanisms (85,86). Reduced CBF can also increase the secretion of aldosterone from the adrenals, which in turn can contribute to cardiac remodeling following BCAS.…”

Lactulose Improves Neurological Outcomes by Repressing Harmful Bacteria and Regulating Inflammatory Reactions in Mice After Stroke

“…Our study showed that IS was elevated after stroke, and lactulose significantly decreased its accumulation. Recently, a study found that stroke may induce kidney dysfunction ( Zhao et al., 2020 ); therefore, IS accumulation may be a potential mechanism of stroke-induced kidney dysfunction.…”

Chronic and End-Stage Kidney Disease in the Neurological Intensive Care Unit

“…16 Patients with ESRD have been shown to have more severe atherosclerotic disease and higher rates of atrial fibrillation, both of which predispose them further to ischemic stroke. 17,18 The relationship between renal disease and stroke is further complicated by data suggesting that ischemic stroke may lead to downstream inflammatory, autonomic and microbiome changes that further worsen renal function, 19 with stroke patients demonstrating higher rates of incident CKD compared to controls. 20…”