More Rapid Progression of Brain Atrophy in Patients on Peritoneal Dialysis Compared with Hemodialysis: The VCOHP Study

Overview

Journal Hypertens Res

Specialty Cardiology & Vascular Diseases

Date 2023 Dec 20

PMID 38123712

Authors

Kazuhiko Tsuruya

Hisako Yoshida

Shunsuke Yamada

Naoki Haruyama

Shigeru Tanaka

Akihiro Tsuchimoto

Masahiro Eriguchi

Kiichiro Fujisaki

Kumiko Torisu

Toshiaki Nakano

Kosuke Masutani

Takanari Kitazono

Affiliations

Soon will be listed here.

Abstract

We previously reported that brain atrophy was more severe and progressed more rapidly in patients with end-stage kidney disease on peritoneal dialysis (PD) than those with non-dialysis-dependent chronic kidney disease. However, it remains unknown whether there is a difference between patients on PD and hemodialysis (HD). In total, 73 PD and 34 HD patients who underwent brain magnetic resonance imaging (MRI) were recruited for a cross-sectional analysis. Among them, 42 PD and 25 HD patients who underwent a second brain MRI after 2 years were recruited for a longitudinal analysis. T1-weighted MRI images were analyzed. Total gray matter volume (GMV), total white matter volume, and cerebrospinal fluid volume were segmented, and each volume was quantified using statistical parametric mapping software. The ratio of GMV (GMR) was calculated by dividing GMV by intracranial volume, to adjust for variations in head size. We compared GMR between PD and HD patients in the cross-sectional analysis and the annual change in GMR (AC-GMR) in the longitudinal analysis. In the cross-sectional analysis, age- and sex-adjusted GMR was significantly lower in PD than HD patients [least square mean (LSM): 39.2% vs. 40.0%, P = 0.018]. AC-GMR was significantly greater in PD than HD patients and this difference remained significant even after adjustment for potential confounding factors (LSM: -0.68 vs. -0.28 percentage-points/year, P = 0.011). In conclusion, the present study demonstrated a more rapid progression of brain atrophy in PD patients compared with HD patients. We demonstrated that decline in GMR progressed significantly more rapidly in PD than HD patients independent of potential confounding factors. GMR gray matter volume ratio, HD hemodialysis, PD peritoneal dialysis.

Citing Articles

Cognitive Impairment and Brain Atrophy in Patients with Chronic Kidney Disease.

Tsuruya K, Yoshida H J Clin Med. 2024; 13(5).

PMID: 38592226 PMC: 10931800. DOI: 10.3390/jcm13051401.

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