REVIEW article
Front. Endocrinol.
Sec. Renal Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1562518
Crosstalk of Kidney and Brain in Diabetes-related Cognitive Impairment and Therapeutic Strategies
Provisionally accepted
- 1Shandong University, Jinan, China
- 2Shandong Provincial Hospital, Jinan, Shandong Province, China
- 3Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
- 4Shandong Provincial Qianfoshan Hospital, Jinan, Shandong Province, China
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Type 2 diabetes mellitus (T2DM) and its associated complications pose a global health threat. Notably, the rise in diabetes-induced cognitive dysfunction has garnered widespread attention. T2DM patients frequently face an elevated risk of both cognitive impairment and diabetic kidney disease (DKD) comorbidity. There is evidence to suggest that kidney and brain dysfunction share common pathogenic factors, such as vascular endothelial injury, oxidative stress, and inflammation activation. Whereas, the underlying mechanisms of kidney-brain interaction and effective treatments for DKD-related cognitive decline remain incompletely understood. Our review preliminarily summarized the relationship between renal dysfunction and cognitive decline based on the existing clinical trial evidence. The mechanisms underlying DKD-related cognitive decline which mainly included the accumulation of harmful metabolites, inflammation activation and endothelial dysfunction were also clarified. And the brain renin-angiotensin-aldosterone system (RAAS) may serve as a bridge connecting renal dysfunction in DKD with cognitive impairment. In addition, we further concluded that potential lifestyle interventions and pharmacological approaches, including antioxidants, RAS inhibitors, finerenone and hypoglycemic agents, such as sodium-glucose cotransporter-2 inhibitors, liraglutide and pioglitazone may exert the preservation of cognitive function. The review could offer valuable insights for therapeutic strategies of cognitive impairment associated with diabetes and DKD in future.
Keywords: Diabetes Mellitus, Diabetic kidney disease, cognitive impairment, crosstalk, pharmacological therapy
Received: 17 Jan 2025; Accepted: 12 Aug 2025.
Copyright: © 2025 Xu, Miao, Chen and Liao. 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) or licensor 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.
* Correspondence:
Yongjun Chen, Shandong University of Traditional Chinese Medicine, Jinan, 250355, Shandong Province, China
Lin Liao, Shandong Provincial Qianfoshan Hospital, Jinan, 250014, Shandong Province, China
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