Cerebrovascular effects of hemodialysis in chronic kidney disease.

Cerebrovascular effects of hemodialysis in chronic kidney disease. Research Abstract Details 

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Cerebrovascular effects of hemodialysis in chronic kidney disease. Abstract Text:

Isak Prohovnik,James Post,Jaime Uribarri,Hedok Lee,Oana Sandu,Erik Langhoff,

Patients with end-stage renal disease (ESRD) undergoing hemodialysis are known to suffer cognitive deficits and stroke of unknown etiology. It has been suspected that the treatment itself may contribute to the syndrome by unknown mechanisms, which we investigated in this study. End-stage renal disease patients on hemodialysis (n=19) or peritoneal dialysis (PD, n=5) were compared with 14 healthy controls. Subjects participated in magnetic resonance imaging (MRI) measurements of cerebral atrophy, cerebral blood flow (CBF) arterial spin labeled-MRI (ASL-MRI), quantitative Doppler blood flow through the internal carotid artery, and cerebral oxymetry. The Doppler and oxymetry procedures were also performed at the beginning and end of a single hemodialysis session. End-stage renal disease patients on hemodialysis showed significant cerebral atrophy, associated with longer hemodialysis duration and cognitive deficits, including focal bilateral lesions in the caudate nucleus and midbrain. Cerebral oxygenation was extremely low before dialysis (rSO(2) 41+/-13, compared with 70+/-2 in controls, P<0.02) and improved only slightly after dialysis. Carotid blood flow was also very low at the start of dialysis (115+/-28 mL/sec, versus 193+/-56 in controls, P<0.005) but normalized at the end of the session (181 mL/sec). The PD patients showed intermediate values, between the hemodialysis and controls. Notably, duration of hemodialysis treatment predicted global gray-matter volume (r=-0.74), change of blood flow during dialysis (r=-0.65), and baseline rSO(2) (r=-0.65). The findings suggest that ESRD patients on hemodialysis suffer low CBF during the interdialytic cycle. Coupled with low cerebral oxygenation levels and atherosclerosis, this may contribute significantly to the etiology of the observed cerebral atrophy, cognitive deficits, and high stroke prevalence.

Cerebrovascular effects of hemodialysis in chronic kidney disease. Publishing Authors By Initials

I Prohovnik,J Post,J Uribarri,H Lee,O Sandu,E Langhoff,

For similar therapeutics: renal replacement therapy: renal dialysis research abstracts see: therapeutics: renal replacement therapy: renal dialysis research

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Cerebrovascular effects of hemodialysis in chronic kidney disease. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Journal of cerebral blood flow and metabolism : of

VOLUME: 27

Page Numbers: 1861-9

Journal Abbreviation: J. Cereb. Blood Flow Metab.

ISSN: 0271-678X

DAY: 4

MONTH: 04

YEAR: 2007

Cerebrovascular effects of hemodialysis in chronic kidney disease. Information

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LANGUAGE: eng

NlmUniqueID: 8112566

Cerebrovascular effects of hemodialysis in chronic kidney disease. Keywords Mesh Terms:

KEYWORDS: Renal Dialysis

MESH TERMS: adverse effects

Chemical & Substance for Abstract: Cerebrovascular effects of hemodialysis in chronic kidney disease. Information

Substance Name: Oxygen

Registry Number: 7782-44-7

Grant and Affiliation Information for Cerebrovascular effects of hemodialysis in chronic kidney disease.

AFFILIATION: Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA. isak.prohovnik@mssm.edu

Country: United States

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MEDLINETA: J Cereb Blood Flow Metab

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