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Cerebral white matter burden is linked to cognitive function in patients undergoing hemodialysis

Tsai-Shan Wu1, Ping-Hsun Wu2,3,4, Hsiu-Fen Lin5

  • 1Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Annals of Medicine
|February 7, 2024
PubMed
Abstract

Insights

Chronic kidney disease patients undergoing hemodialysis show cognitive decline linked to white matter changes. Periventricular white matter hyperintensities (PVWMHs) significantly correlate with poorer performance on cognitive tests.

Area of Science:

  • Nephrology
  • Neurology
  • Radiology

Background:

  • Chronic kidney disease (CKD) is associated with neurodegeneration and cognitive impairment.
  • White matter hyperintensities (WMHs), assessed by the Fazekas scale, are linked to cognitive decline.

Purpose of the Study:

  • To investigate the association between Fazekas scale scores and cognitive function in hemodialysis patients.
  • To evaluate cognitive performance using MMSE, MoCA, and CASI in relation to WMHs.

Main Methods:

  • 59 hemodialysis patients underwent brain MRI to grade periventricular (PV) and deep (DWMHs) WMHs using the Fazekas scale.
  • Cognitive function was assessed using the Mini-Mental Status Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Cognitive Abilities Screening Instrument (CASI).
  • Multivariable regression models identified associations between cognitive scores and Fazekas scale grading.

Main Results:

  • Inverse associations were found between cognitive tests (MMSE, MoCA, CASI) and PVWMHs (p < .05).
  • Associations were weaker for deep WMHs (DWMHs).
  • PVWMHs significantly impacted CASI subdomains including memory, language, and fluency; DWMHs affected abstract thinking and short-term memory.

Conclusions:

  • Periventricular white matter hyperintensities are inversely correlated with cognitive function in hemodialysis patients.
  • Cognitive performance, including memory and language, is significantly associated with PVWMHs in this population.
Keywords:
Brain magnetic resonance imagingFazekas scalecognitive functionhemodialysis

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