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The regional cerebral blood flow in patients under chronic hemodialytic treatment
D Gottlieb1, B Mildworf, D Rubinger
1Department of Neurology, Hadassah University Hospital, Jerusalem, Israel.
Insights
Chronic hemodialysis patients showed a mild, yet statistically significant, 7% reduction in regional cerebral blood flow (rCBF) after treatment. This decrease in brain blood flow did not correlate with neurological or cognitive impairments.
Area of Science:
- Nephrology
- Neurology
- Medical Imaging
Background:
- Chronic kidney disease (CKD) patients undergoing hemodialysis often experience neurological complications.
- Regional cerebral blood flow (rCBF) is a key indicator of brain health and function.
Purpose of the Study:
- To investigate the impact of a single hemodialysis session on rCBF in chronic hemodialysis patients.
- To assess if changes in rCBF correlate with neurological or cognitive status.
Main Methods:
- Xenon-133 inhalation method was used to measure rCBF.
- Nine chronic hemodialysis patients were evaluated before and after a single hemodialytic treatment.
- Neurological, neuropsychological, and biochemical assessments were performed concurrently.
Main Results:
- Predialysis rCBF values were comparable to age-matched healthy controls.
- A mean reduction of 7% (p = 0.02) in rCBF was observed post-hemodialysis.
- No significant neurological or cognitive dysfunction was associated with the posthemodialysis rCBF reduction.
Conclusions:
- Hemodialysis can induce a mild decrease in regional cerebral blood flow.
- The underlying mechanisms for this rCBF reduction remain unclear.
- Potential contributing factors include increased blood viscosity and biochemical alterations like urea reduction and alkalinization.
Abstract:
Regional cerebral blood flow (rCBF) was measured by the xenon-133 inhalation method in an unselected group of nine chronic hemodialysis patients before and after a single hemodialytic treatment. All patients underwent neurological, neuropsychological, and biochemical evaluations on the same occasions. Predialysis rCBF values did not differ from those obtained in age-matched normal controls. Following hemodialysis, there was a mild reduction in the rCBF by a mean of 7 +/- 2.6% (p = 0.02). The posthemodialysis rCBF reduction was not associated with any neurological or cognitive dysfunction. The causes of hemodialysis-induced rCBF decreases are unknown, but increased blood viscosity and biochemical changes, such as urea reduction and blood alkalinization, may play a role.