Symptom 6. Confusion and Mental Changes: The Cognitive Impact of Acute Kidney Disease
Acute kidney injury can extend its reach beyond the obvious physical symptoms, impacting the brain’s function and leading to confusion and other mental changes. Such cognitive changes might seem unexpected in a disease primarily affecting the kidneys, but they provide crucial insight into AKI’s systemic nature.
When kidneys are functioning optimally, they filter the blood, removing waste products and excess fluids. However, during AKI, this critical filtration process is hindered, resulting in a condition known as uremia. Uremia refers to the excessive accumulation of waste products, usually filtered out by the kidneys, in the bloodstream.
This build-up of waste can have widespread effects on the body, including the brain. Uremic toxins can cross the blood-brain barrier, a protective layer shielding the brain from harmful substances. Once inside the brain, these toxins can disrupt the normal functioning of neurons, leading to cognitive changes such as confusion, decreased concentration, memory problems, and even seizures in severe cases.
Another factor that can contribute to mental changes in AKI is electrolyte imbalance. Electrolytes like sodium, potassium, and calcium play pivotal roles in transmitting signals between nerve cells. When kidney function is compromised, these electrolytes can fall out of balance, disrupting normal neural activity and leading to mental changes.
Moreover, AKI can sometimes cause a condition called dialysis disequilibrium syndrome in individuals receiving dialysis treatment. This syndrome occurs when waste products are removed too quickly from the blood, leading to a disparity in toxin concentrations between the brain and the blood, resulting in cerebral edema or brain swelling. This can manifest as confusion, disorientation, and in severe cases, coma or death.
These cognitive changes can be distressing not only for the individual experiencing them but also for their loved ones. They serve as a potent reminder of how interconnected our body systems truly are, and that a disturbance in one organ can reverberate through the entire body. (6)
