Cerebral hemodynamics in peritoneal dialysis versus intermittent hemodialysis: A transcranial Doppler pilot study

Area of Science:

• Nephrology
• Neurology
• Medical Imaging

Background:

• Cerebral hemodynamics during dialysis can be affected by treatment type.
• Transcranial Doppler (TCD) is a non-invasive tool to assess blood flow in the brain.

Purpose of the Study:

• To compare intradialytic cerebral hemodynamics between intermittent hemodialysis (iHD) and nightly peritoneal dialysis (NIPD).
• To evaluate intradialytic cerebral volatility (IDCV) as a metric for cerebral blood flow stability.

Main Methods:

• Serial transcranial Doppler (TCD) measurements of mean flow velocity (MFV), pulsatility index (PI), and mean arterial pressure (MAP) in 10 iHD and 10 NIPD patients.
• Linear mixed models were used to analyze changes over time.
• Intradialytic cerebral volatility (IDCV) calculated using coefficient of variation (CV) and absolute value of change (AVC).

Main Results:

• No significant difference in the change of MFV, PI, and MAP over time between iHD and NIPD groups.
• Significantly higher CV and AVC values for MFV, PI, and MAP in the iHD group compared to the NIPD group.
• Cerebral hemodynamics (PI, MFV, MAP) were more stable during NIPD than iHD.

Conclusions:

• Nightly peritoneal dialysis (NIPD) leads to more stable intradialytic cerebral hemodynamics compared to intermittent hemodialysis (iHD).
• Intradialytic cerebral volatility (IDCV) is a novel and useful metric for assessing cerebral hemodynamic stability during dialysis.