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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
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Cognitive impairment and microvascular function in end-stage renal disease
Susanne Angermann1, Roman Günthner1, Henner Hanssen2
1Department of Nephrology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munchen, Germany.
International Journal of Methods in Psychiatric Research
|March 15, 2022
Summary
Cognitive impairment is common in hemodialysis patients. This study links impaired executive function to reduced retinal arteriolar response, suggesting small vessel disease impacts cognition in these patients.
Area of Science:
- Nephrology
- Neurology
- Ophthalmology
Background:
- Hemodialysis patients exhibit a significantly higher prevalence of cognitive impairment than the general population.
- Impaired microcirculatory function is a suspected cause of cognitive decline in this group.
- Dynamic retinal vessel analysis offers a method to assess neurovascular coupling and microvascular endothelial function.
Purpose of the Study:
- To investigate the association between cognitive impairment and retinal microcirculation in chronic hemodialysis patients.
- To determine if retinal microvascular function serves as a surrogate for cerebral microvascular function and cognition.
Main Methods:
- 152 chronic hemodialysis patients completed cognitive testing using the Montreal Cognitive Assessment.
- Retinal microcirculation was evaluated using Dynamic Retinal Vessel Analysis with a flicker light stimulus.
Main Results:
- A significant association was found between the visuospatial executive function score and maximum arteriolar dilation in response to flicker light stimulation.
- This relationship remained significant in both unadjusted and adjusted linear regression analyses.
Conclusions:
- This study is the first to assess retinal microvascular function as a proxy for cerebral microvascular function and cognition in hemodialysis patients.
- The findings support the role of cerebral small vessel disease in cognitive impairment development within this population.
- Retinal vessel analysis may offer a noninvasive approach for monitoring and therapeutic interventions.
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