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2014 ; 93
(28
): e313
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Diffuse interstitial brain edema in patients with end-stage renal disease
undergoing hemodialysis: a tract-based spatial statistics study
#MMPMID25526483
Kong X
; Wen JQ
; Qi RF
; Luo S
; Zhong JH
; Chen HJ
; Ji GJ
; Lu GM
; Zhang LJ
Medicine (Baltimore)
2014[Dec]; 93
(28
): e313
PMID25526483
show ga
To investigate white matter (WM) alterations and their correlation with cognition
function in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD)
using diffusion tensor imaging (DTI) with tract-based spatial statistics (TBSS)
approach. This prospective HIPAA-complaint study was approved by our
institutional review board. Eighty HD ESRD patients and 80 sex- and age-matched
healthy controls were included. Neuropsychological (NP) tests and laboratory
tests, including serum creatinine and urea, were performed. DTI data were
processed to obtain fractional anisotropy (FA) and mean diffusivity (MD) maps
with TBSS. FA and MD difference between the 2 groups were compared. We also
explored the associations of FA values in WM regions of lower FA with ages, NP
tests, disease, and dialysis durations, serum creatinine and urea levels of ESRD
patients. Compared with controls, HD ESRD patients had lower FA value in the
corpus callosum, bilateral corona radiate, posterior thalamic radiation, left
superior longitudinal fasciculus, and right cingulum (P<0.05, FWE corrected).
Almost all WM regions had increased MD in HD ESRD patients compared with controls
(P<0.05, FWE corrected). In some regions with lower FA, FA values showed moderate
correlations with ages, NP tests, and serum urea levels. There was no correlation
between FA values and HD durations, disease durations, and serum creatinine
levels of ESRD patients (all P>0.05). Diffuse interstitial brain edema and
moderate WM integrity disruption occurring in HD ESRD patients, which correlated
with cognitive dysfunction, and serum urea levels might be a risk factor for
these WM changes.