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Abstract: TH-PO317

Memory Deficit in Hemodialysis Patients: Clinical Characteristics and Cerebral Imaging Findings

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Liu, Wenjin, Nanjing Medical University, Nanjing, JIangSu, China
  • Wang, Lulu, Nanjing Medical University, Nanjing, JIangSu, China
  • Yang, Junwei, Center for Kidney Disease, Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
Background

The current study aimed to investigate the characteristics of memory deficit in dialysis patients, as well as using magnetic resonance imaging (MRI) to explore associated cerebral structural and functional changes.

Methods

Sixty patients on maintenance hemodialysis and 60 healthy controls were included. Patients and controls were frequency-matched by age, sex and education. All subjects underwent evaluation of global cognition (The Montreal Cognitive Assessment, MoCA) and episodic memory (Auditory Verbal Learning Test, AVLT). Brain structure and function were evaluated using MRI with 3DT1 and BOLD (blood-oxygen-level dependent) sequences. Voxel-based morphometry (VBM) was used to calculate grey matter volume while ReHo (regional homogeneity) was calculated to assess brain activity.

Results

Compared with controls, patients had significantly lower scores of MoCA and AVLT (learning memory, short delayed recall, long delayed recall). The memory curve plot based on AVLT results demonstrate that patients had a similar memory curve from learning memory to short delayed memory, whereas their memory declined significantly from short delayed recall to long delayed recall while the controls’ memory remained stable during this period. Multiple stepwise regression analysis revealed that end-stage renal disease is associated with memory deficit independently. VBM revealed that dialysis patients have significantly reduced grey matter volume in the following area: right cerebellum anterior lobe, bilateral cerebellum posterior lobe, right hippocampus, amygdala, parahippocampus gyrus, left medial frontal gyrus, left fusiform gyrus, bilateral caudate and subcallosal gyrus and left insula. fMRI showed that ReHo declined in dialysis in the left middle and inferior frontal gyrus, as well as in the right supra marginal gyrus. Correlation analysis demonstrated that ReHo of left middle/inferior frontal gyrus correlated with learning memory test score (r=0.34,p=0.02).

Conclusion

Our study reveals memory deficit with a special pattern in dialysis patients, as well as that dialysis patients are with diffuse cerebral atrophy and reduced brain functional activity in certain areas. Cerebral functional changes are associated with memory alterations in the patients.

Funding

  • Government Support - Non-U.S.