Abnormal Dynamic Functional Connectivity in Patients With End-Stage Renal Disease
Xuekun Li1, Ruifang Yan1, Zheng Yue1
1Department of Magnetic Resonance, First Affiliated Hospital of Xinxiang Medical University, Weihui, China.
Frontiers in Neuroscience
|June 7, 2022
Summary
End-stage renal disease (ESRD) patients exhibit altered brain connectivity patterns, with hemodialysis potentially worsening these dynamic functional connectivity deficits and impacting cognitive function.
Area of Science:
- Neuroscience
- Medical Imaging
- Systems Biology
Background:
- Dynamic functional connectivity (FC) analysis reveals time-varying brain network properties.
- Limited research exists on dynamic FC in end-stage renal disease (ESRD).
Purpose of the Study:
- To investigate dynamic whole-brain FC and topological properties in ESRD patients.
- To compare dynamic FC between hemodialysis (HD) patients, non-dialysis ESRD patients, and healthy controls (HCs).
Main Methods:
- Resting-state functional magnetic resonance imaging (fMRI) data from 100 ESRD patients and 64 HCs.
- Independent component analysis, sliding-window approach, and graph theory to analyze dynamic FC.
- Clustering of intrinsic brain FC into four configuration states.
Main Results:
- ESRD patients, particularly HD patients, spent more time in a specific connectivity state (State 3) with reduced default mode network (DMN) connectivity.
- Hemodialysis patients showed further reductions in DMN connectivity compared to non-dialysis patients.
- Decreased network flexibility (fewer transitions, reduced global/local efficiency) was observed in ESRD patients, worsening with HD.
- Increased time in State 3 and reduced transitions correlated with poorer performance on cognitive tests (Trail Making Test A and B).
Conclusions:
- ESRD is associated with impaired functional flexibility and state-specific FC disruptions, potentially explaining cognitive deficits.
- Hemodialysis may adversely affect time-varying brain functional connectivity in ESRD patients.
Related Concept Videos
01:28Chronic Kidney Disease III: Interprofessional Care
89
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
89
01:25Chronic Kidney Disease I: Introduction
84
Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
84
01:24Chronic Kidney Disease II: Clinical Manifestations
110
Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
110
01:27Dialysis
505
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
505
01:17Factors Affecting Renal Clearance: Renal Impairment
167
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
167
01:29Acute Kidney Injury II: Pathophysiology
101
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
101