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Cognition may be related to arterial pulsatility index in HD patients

James B Post1, Kel G Morin, John P Handrakis

  • 1Nephrology Division, VA RR&D Center of Excellence for Medical Consequences of SCI, James J. Peters Veterans Affairs Medical Center, Bronx, NY, Department of Physical Therapy, School of Health Professionals, New York Institute of Technology, Old Westbury, NY, VA RR&D, James J. Peters Veterans Affairs Medical Center, Bronx, NY, Departments of Medicine, Psychiatry, and Rehabilitation Medicine, Mount Sinai School of Medicine, NY, USA.

Clinical Nephrology
|May 1, 2014
PubMed

Insights

Common carotid artery pulsatility index (CCAPI) may indicate cognitive decline in hemodialysis patients. Higher CCAPI in hemodialysis patients correlates with poorer attention and reflects cerebral microvascular disease.

Area of Science:

  • Nephrology
  • Neurology
  • Vascular Biology

Background:

  • Hemodialysis (HD) patients exhibit significant subclinical cerebrovascular disease and cognitive impairment.
  • Pulsatility index is linked to cerebral microangiopathy and stroke risk.

Purpose of the Study:

  • To investigate the relationship between common carotid artery pulsatility index (CCAPI) and cognitive function in hemodialysis patients without a history of stroke or dementia.
  • To compare CCAPI and cognitive performance between well-dialyzed HD patients and matched controls.

Main Methods:

  • An observational, cross-sectional study involving 37 hemodialysis outpatients and 18 healthy controls.
  • CCAPI and cognitive function were assessed. Statistical analyses included non-parametric tests, multiple regression, and ANOVA to control for confounding factors.

Main Results:

  • Hemodialysis patients demonstrated significantly higher CCAPI compared to controls (2.1 ± 0.4 vs. 1.7 ± 0.3 cm/s).
  • HD patients showed lower scores across all cognitive domains.
  • CCAPI correlated negatively with attention in HD patients, independent of traditional cardiovascular risk factors and duration of HD.
  • CCAPI also correlated with the duration of hemodialysis, irrespective of other risk factors.

Conclusions:

  • CCAPI may serve as a potential biomarker for cognitive impairment in hemodialysis patients.
  • Elevated CCAPI in HD patients could indicate underlying cerebral microvascular disease, even in the absence of overt neurological events.
Abstract

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