Chronic Kidney disease and stroke: A Bi-directional risk cascade and therapeutic update

Chronic kidney disease causes a myriad of changes in the normal physiology of the body. Inflammation, atherosclerosis, vascular calcification, the effect of uremic toxins, cerebral blood flow dysautoregulation, dialysis techniques, vascular access, prothrombotic tendency, and anticoagulation are just some of the changes which form a part of the cascade. Stroke is intimately associated with this disease process and it is difficult to manage both simultaneously. In this review, we have narrated to outline the pathophysiological cascade behind each of the two disease processes that how they interact with each other. In this review we have focused on possible therapeutic options exist to manage both with special emphasis on antiplatelets, miRNA, and pre and probiotics. This review exist all the possible pathological pathways and therapeutic targets in such dual cascade that will be very useful for the clinicians while dealing in this complex interplay.