Publication
Hemodialysis Induces an Acute Decline in Cerebral Blood Flow in Elderly Patients
Polinder-Bos, H., Vállez García, D., Kuipers, J., Elting, J. W. J., Aries, M. J. H., Krijnen, W. P., Groen, H., Willemsen, A., van Laar, P., Strijkert, F., Luurtsema, G., Slart, R., Westerhuis, R., Gansevoort, R. T., Gaillard, C. A. & Franssen, C., Apr-2018, In : Journal of the American Society of Nephrology. 29, 4, p. 1317-1325 9 p.Research output: Contribution to journal › Article › Academic › peer-review

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- Hemodialysis Induces an Acute Decline in Cerebral Blood Flow in Elderly Patients
Final publisher's version, 869 KB, PDF document
DOI
- Methods in Medicines evaluation & Outcomes research (M2O)
- Reproductive Origins of Adult Health and Disease (ROAHD)
- Center for Medical Imaging (CMI)
- Molecular Neuroscience and Ageing Research (MOLAR)
- Cardiovascular Centre (CVC)
- Groningen Kidney Center (GKC)
- Translational Immunology Groningen (TRIGR)
- Value, Affordability and Sustainability (VALUE)
The initiation of hemodialysis is associated with an accelerated decline of cognitive function and an increased incidence of cerebrovascular accidents and white matter lesions. Investigators have hypothesized that the repetitive circulatory stress of hemodialysis induces ischemic cerebral injury, but the mechanism is unclear. We studied the acute effect of conventional hemodialysis on cerebral blood flow (CBF), measured by [O-15]H2O positron emission tomography-computed tomography (PET-CT). During a single hemodialysis session, three [O-15]H2O PET-CT scans were performed: before, early after the start of, and at the end of hemodialysis. We used linear mixed models to study global and regional CBF change during hemodialysis. Twelve patients aged >= 65 years (five women, seven men), with a median dialysis vintage of 46 months, completed the study. Mean (+/- SD) arterial BP declined from 101 +/- 11 mm Hg before hemodialysis to 93 +/- 17 mm Hg at the end of hemodialysis. From before the start to the end of hemodialysis, global CBF declined significantly by 10%+/- 615%, from a mean of 34.5 to 30.5 ml/100g per minute (difference, -4.1 ml/100 g per minute; 95% confidence interval, -7.3 to -0.9 ml/100 g per minute; P=0.03). CBF decline (20%) was symptomatic in one patient. Regional CBF declined in all volumes of interest, including the frontal, parietal, temporal, and occipital lobes; cerebellum; and thalamus. Higher tympanic temperature, ultrafiltration volume, ultrafiltration rate, and pH significantly associated with lower CBF. Thus, conventional hemodialysis induces a significant reduction in global and regional CBF in elderly patients. Repetitive intradialytic decreases in CBF may be one mechanism by which hemodialysis induces cerebral ischemic injury.
Original language | English |
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Pages (from-to) | 1317-1325 |
Number of pages | 9 |
Journal | Journal of the American Society of Nephrology |
Volume | 29 |
Issue number | 4 |
Early online date | 1-Mar-2018 |
Publication status | Published - Apr-2018 |
- CHRONIC KIDNEY-DISEASE, STAGE RENAL-DISEASE, CIRCULATING ENDOTHELIAL-CELLS, POSITRON-EMISSION-TOMOGRAPHY, WHITE-MATTER, DIFFUSION-TENSOR, INTRAVENOUS (H2O)-O-15, COGNITIVE IMPAIRMENT, DIALYSIS INITIATION, RISK-FACTORS
Keywords
Related Press / Media
Hemodialysis Induces an Acute Decline in Cerebral Blood Flow in Elderly Patients
Harmke Polinder-Bos & David Vallez Garcia
02/03/2018
1 item of Media coverage
Press/Media: Research › Popular
Related Prizes
Top 5 best publications in 2018 by the Journal of the American Society of Nephrology
Harmke Bos (Recipient), David Vállez García (Recipient), Johanna Kuipers (Recipient), Jan Willem J. Elting (Recipient), Marcel J.H. Aries (Recipient), Wim P. Krijnen (Recipient), Henk Groen (Recipient), Antoon Willemsen (Recipient), Peter van Laar (Recipient), Fijanne Strijkert (Recipient), Gert Luurtsema (Recipient), Riemer Slart (Recipient), Ralf Westerhuis (Recipient), Ron T. Gansevoort (Recipient), Carlo A. Gaillard (Recipient) & Casper Franssen (Recipient), 2019
Prize › Academic
Publication Price 2018 for established researchers
Harmke Polinder-Bos (Recipient), David Vállez García (Recipient), Johanna Kuipers (Recipient), Jan Willem J. Elting (Recipient), Marcel J.H. Aries (Recipient), Wim P. Krijnen (Recipient), Henk Groen (Recipient), Antoon Willemsen (Recipient), Peter van Laar (Recipient), Fijanne Strijkert (Recipient), Gert Luurtsema (Recipient), Riemer Slart (Recipient), Ralf Westerhuis (Recipient), Ron T. Gansevoort (Recipient), Carlo A. Gaillard (Recipient) & Casper Franssen (Recipient), Mar-2019
Prize › Academic
ID: 54920574