Brain injury and the kidney

INTRODUCTION

Brain injury affects kidney function and kidney injury affects brain; is it a cross-correlation or interconnection or a vicious cycle?

Afferent impulses from central nervous system (CNS) regulate renal blood flow, glomerular filtration rate and renal sodium handling.[1] On the other hand, impulses originating from the kidney are carried via unmyelinated and thinly myelinated fibres to the CNS and the contralateral kidney to regulate CNS activity and coordinate renal sodium handling.

Both organs have a common feature of a tight auto-regulatory mechanism that maintains constant blood flow over a wide range of blood pressures. It is unclear whether these mechanisms are interconnected.[2]

The incidence of acute renal dysfunction and renal failure after cerebral injury is diversely reported to be ranging from 8% to 23% and 0.5% to 0.8%, respectively, in different studies.[2]

Renal problems can occur in various acute cerebral insults such as cerebral ischaemic stroke, subarachnoid haemorrhage, intracerebral haemorrhage, head injury and white matter lesions.[3] [4] [5]

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