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      Behavioral Changes During Development of Chronic Kidney Disease in Rats

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          Abstract

          Decreased renal function due to chronic kidney disease (CKD) is associated with anxiety and cognitive decline. Although these mental disorders are often obvious in late stage renal disease patients, they might be unnoticeable or are neglected in early stages of the CKD development. Associations between renal and cognitive dysfunction have been indicated by studies performed mainly in patients undergoing dialysis, which itself represents a stress and decreased quality of life. However, experimental and causal studies are scarce. Our aim was to investigate dynamic changes in behavioral traits during the progression of CKD in an animal model. Thirty 12-week old male rats were used in this experiment. CKD was induced by a subtotal (5/6) nephrectomy. Two, 4, and 6 months after surgical induction of CKD, the open field, the light-dark box and the novel object recognition tests were conducted to assess the locomotor activity, anxiety-like behavior and the memory function of rats. Blood urea nitrogen (BUN), plasma concentration of creatinine (CREAT), albumin to creatinine ratio in urine (ACR) along with the renal histology were assessed to monitor the development and severity of CKD. In comparison to control rats, 5/6 nephrectomized rats had by 46–66% higher concentration of BUN during the whole follow-up period, as well as by 52% and by 167% higher CREAT and ACR, respectively, 6 months after surgery. Although the effect of time was observed in some behavioral parameters, nephrectomy did not significantly influence either locomotor activity, or anxiety-like behavior, or memory function of animals. Two and 4 months after surgery, animals moved shorter distance and spent less time in the center zone. However, the open-field ambulation returned back to the baseline level 6 months after CKD induction. Although nephrectomized rats displayed impaired kidney function as early as 2 months after surgery, no significant differences were found between the CKD and the control rats in any of the observed behaviors. Further studies are needed in order to evaluate whether behavioral abnormalities are related to severity of CKD or might be attributed to psychosocial aspect of end-stage renal disease and decreased quality of life in dialysis patients.

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          Most cited references51

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          Chronic kidney disease

          Chronic kidney disease (CKD) is defined by persistent urine abnormalities, structural abnormalities or impaired excretory renal function suggestive of a loss of functional nephrons. The majority of patients with CKD are at risk of accelerated cardiovascular disease and death. For those who progress to end-stage renal disease, the limited accessibility to renal replacement therapy is a problem in many parts of the world. Risk factors for the development and progression of CKD include low nephron number at birth, nephron loss due to increasing age and acute or chronic kidney injuries caused by toxic exposures or diseases (for example, obesity and type 2 diabetes mellitus). The management of patients with CKD is focused on early detection or prevention, treatment of the underlying cause (if possible) to curb progression and attention to secondary processes that contribute to ongoing nephron loss. Blood pressure control, inhibition of the renin-angiotensin system and disease-specific interventions are the cornerstones of therapy. CKD complications such as anaemia, metabolic acidosis and secondary hyperparathyroidism affect cardiovascular health and quality of life, and require diagnosis and treatment.
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            Chronic kidney disease as cause of cardiovascular morbidity and mortality.

            To make an evidence-based evaluation of the relationship between kidney failure and cardiovascular risk, we reviewed the literature obtained from a PubMed search using pre-defined keywords related to both conditions and covering 18 years (1986 until end 2003). Eighty-five publications, covering 552 258 subjects, are summarized. All but three studies support a link between kidney dysfunction and cardiovascular risk. More importantly, the association is observed very early during the evolution of renal failure: an accelerated cardiovascular risk appears at varying glomerular filtration rate (GFR) cut-off values, which were >/=60 ml/min in at least 20 studies. Many studies lacked a clear definition of cardiovascular disease and/or used a single determination of serum creatinine or GFR as an index of kidney function, which is not necessarily corresponding to well-defined chronic kidney disease. In six studies, however, chronic kidney dysfunction and cardiovascular disease were well defined and the results of these confirm the impact of kidney dysfunction. It is concluded that there is an undeniable link between kidney dysfunction and cardiovascular risk and that the presence of even subtle kidney dysfunction should be considered as one of the conditions necessitating intensive prevention of this cardiovascular risk.
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              Association between psychosocial stress and hypertension: a systematic review and meta-analysis.

              The etiology of hypertension is various and complex, involving both genetic and behavioral factors. The relationship between psychosocial stress and hypertension has been hypothesized. More and more people experience increased anxiety, depression, and chronic psychosocial stress brought on by globalization, cultural changes, socioeconomic changes, and stress at the work place. Although a plethora of studies have investigated the interaction between psychosocial stress and hypertension, this relationship is still contentious. The objective of this study is twofold. First, a review of recent advancements in our understanding of the relationship between psychosocial stress and hypertension. Second, a meta-analysis aiming to assess the relationship between chronic psychosocial stress and blood pressure.
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                Author and article information

                Contributors
                Journal
                Front Med (Lausanne)
                Front Med (Lausanne)
                Front. Med.
                Frontiers in Medicine
                Frontiers Media S.A.
                2296-858X
                09 January 2020
                2019
                : 6
                : 311
                Affiliations
                [1] 1Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University in Bratislava , Bratislava, Slovakia
                [2] 2Department of Paediatrics, National Institute of Children's Diseases and Faculty of Medicine, Comenius University in Bratislava , Bratislava, Slovakia
                [3] 3Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University in Bratislava , Bratislava, Slovakia
                [4] 4Institute of Phsysiology, Faculty of Medicine, Comenius University in Bratislava , Bratislava, Slovakia
                Author notes

                Edited by: Keisa Williams Mathis, University of North Texas Health Science Center, United States

                Reviewed by: Victor Uteshev, University of North Texas Health Science Center, United States; Kirk Campbell, Icahn School of Medicine at Mount Sinai, United States

                *Correspondence: Emese Renczés renczes.emese@ 123456gmail.com

                This article was submitted to Nephrology, a section of the journal Frontiers in Medicine

                Article
                10.3389/fmed.2019.00311
                6962109
                d6612ab2-5639-435e-aeb0-24be258cb91e
                Copyright © 2020 Renczés, Marônek, Gaál Kovalčíková, Vavrincová-Yaghi, Tóthová and Hodosy.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 17 June 2019
                : 09 December 2019
                Page count
                Figures: 3, Tables: 0, Equations: 0, References: 59, Pages: 8, Words: 6491
                Funding
                Funded by: Agentúra na Podporu Výskumu a Vývoja 10.13039/501100005357
                Funded by: Vedecká Grantová Agentúra MŠVVaŠ SR a SAV 10.13039/501100006109
                Categories
                Medicine
                Original Research

                cognition,dementia,mental health,neurological complications,renal failure

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