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Dialysis adequacy and hemoglobin levels predict cerebral atrophy in maintenance-hemodialysis patients
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Cao, Ming-Xuan, Xiao, Jia, Qin, Hua-Min, Wang, Zhi-Hong, Boltze, Johannes, Liu, Shu-Xin and Li, Shen (2023) Dialysis adequacy and hemoglobin levels predict cerebral atrophy in maintenance-hemodialysis patients. Journal of Cerebral Blood Flow & Metabolism . 0271678X2311516. doi:10.1177/0271678x231151621 ISSN 0271-678X. (In Press)
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Official URL: https://doi.org/10.1177/0271678x231151621
Abstract
The pathogenesis of cerebral atrophy (CA) is not clear. Previous studies show a high incidence of preterm CA in hemodialysis patients. This study aims to investigate the factors influencing CA and to derive a CA prediction nomogram in maintenance-hemodialysis patients. First, brain volumes of hemodialysis patients (≤55 years) were compared against age- and sex-matched healthy controls, and differences were revealed in bilateral insular cisterns width, maximum cerebral sulci width, Evans index, ventricular-brain ratio, frontal atrophy index, and temporal lobe ratio. Then, the patients were divided equally into “no or mild” or “severe” CA groups. Potential factors influencing CA were screened. Kt/V (urea removal index) and hemoglobin levels negatively correlated with CA degree, and were used to establish a nomogram within randomly assigned training and validation patient groups. The areas under the receiver operating characteristic curves (AUROC) for training and validation groups were 0.703 and 0.744, respectively. When potassium and calcium were added to the nomogram, the AUROC for training/validation group increased to 0.748/0.806. The nomogram had optimal AUROC for training (0.759) and validation (0.804) groups when albumin was also included. Hemodialysis patients showed reduced anterior brain volumes and the nomogram established herein may have predictive value for developing CA.
| Item Type: | Journal Article | ||||||
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| Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) | ||||||
| SWORD Depositor: | Library Publications Router | ||||||
| Journal or Publication Title: | Journal of Cerebral Blood Flow & Metabolism | ||||||
| Publisher: | Nature Publishing Group | ||||||
| ISSN: | 0271-678X | ||||||
| Official Date: | 18 January 2023 | ||||||
| Dates: |
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| Article Number: | 0271678X2311516 | ||||||
| DOI: | 10.1177/0271678x231151621 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | In Press | ||||||
| Reuse Statement (publisher, data, author rights): | Cao M-X, Xiao J, Qin H-M, et al. Dialysis adequacy and hemoglobin levels predict cerebral atrophy in maintenance-hemodialysis patients. Journal of Cerebral Blood Flow & Metabolism. 2023;0(0). 10.1177/0271678X231151621 Copyright © 2023 (Copyright Holder). Reprinted by permission of SAGE Publications. https://doi.org/10.1177/0271678x231151621 (http://journals.sagepub.com). | ||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||
| Copyright Holders: | © The Author(s) 2023. | ||||||
| Date of first compliant deposit: | 23 February 2023 | ||||||
| Date of first compliant Open Access: | 23 February 2023 |
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