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2015 ; 10
(3
): e0122188
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Increased cerebral water content in hemodialysis patients
#MMPMID25826269
Reetz K
; Abbas Z
; Costa AS
; Gras V
; Tiffin-Richards F
; Mirzazade S
; Holschbach B
; Frank RD
; Vassiliadou A
; Krüger T
; Eitner F
; Gross T
; Schulz JB
; Floege J
; Shah NJ
PLoS One
2015[]; 10
(3
): e0122188
PMID25826269
show ga
Little information is available on the impact of hemodialysis on cerebral water
homeostasis and its distribution in chronic kidney disease. We used a
neuropsychological test battery, structural magnetic resonance imaging (MRI) and
a novel technique for quantitative measurement of localized water content using
3T MRI to investigate ten hemodialysis patients (HD) on a dialysis-free day and
after hemodialysis (2.4±2.2 hours), and a matched healthy control group with the
same time interval. Neuropsychological testing revealed mainly attentional and
executive cognitive dysfunction in HD. Voxel-based-morphometry showed only
marginal alterations in the right inferior medial temporal lobe white matter in
HD compared to controls. Marked increases in global brain water content were
found in the white matter, specifically in parietal areas, in HD patients
compared to controls. Although the global water content in the gray matter did
not differ between the two groups, regional increases of brain water content in
particular in parieto-temporal gray matter areas were observed in HD patients. No
relevant brain hydration changes were revealed before and after hemodialysis.
Whereas longer duration of dialysis vintage was associated with increased water
content in parieto-temporal-occipital regions, lower intradialytic weight changes
were negatively correlated with brain water content in these areas in HD
patients. Worse cognitive performance on an attention task correlated with
increased hydration in frontal white matter. In conclusion, long-term HD is
associated with altered brain tissue water homeostasis mainly in parietal white
matter regions, whereas the attentional domain in the cognitive dysfunction
profile in HD could be linked to increased frontal white matter water content.