Abstract: TH-PO225
Effect of Impaired Orthostatic Blood Pressure Homeostasis on Brain Network in Patients on Maintenance Hemodialysis
Session Information
- Hemodialysis and Frequent Dialysis - I
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Liu, Wenjin, University of Washington, Seattle, Washington, United States
- Shang, Ruihong, Beijing Institute of Technology, Beijing, China
- Wang, Lulu, Center for Kidney Disease, Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Zhu, Yifan, Beijing Institute of Technology, Beijing, China
- Yuan, Chun, University of Washington, Seattle, Washington, United States
- Li, Xuesong, Beijing Institute of Technology, Beijing, China
- Yang, Junwei, Center for Kidney Disease, Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
Background
Patients with renal failure are at excessive risk of developing impaired orthostatic BP homeostasis. We have recently demonstrated that it is associated with memory deficit in dialysis patients. However, the neurobiological basis of this link remains poorly understood. The aim of this study was to evaluate the effect of impaired orthostatic BP homeostasis on brain network in ESKD patients leveraging the advances of graph-theory based network analysis and machine learning.
Methods
This is a data-driven analysis of the baseline neuroimaging data from an ongoing prospective cohort study which has enrolled 166 dialysis patients. Patients were excluded if they had a previous history of stroke or any other neurologic disease.
Results
Orthostatic BP reduction was defined as seated systolic / diastolic BP minus the minimum of three standing systolic / diastolic BPs. Functional, structural, and diffusion MRI data sets were obtained with a 3T scanner. After preprocessing, we constructed the whole-brain structural and functional networks using GRETNA software. We combine powerful MRI and machine learning to decode the relationship. Whole-brain structural connectivity (SC) and SC strength (SCs) were extracted as prediction features. After selecting significant features by Pearson coefficient from 141 participants, we use Extremely Randomized Tree model and the predict error is measured by Mean absolute error, Mean Square Error or corrections between actual and predicted values. By using the most accurate predicting model, we further investigate the biologic essence provided by the predicting model. The data showed that the connections of BG-MTG and Amyg-FuG is stronger than other regions in predicting systolic orthostatic blood pressure reduction, while the connections strength in Amyg-pSTS holds the major contribution in predicting diastolic reduction.
Conclusion
Our analysis suggests that impaired orthostatic BP homeostasis has a significant effect on brain network in dialysis patients. These results provide further insight into the association between orthostatic hypotension and cognitive impairment and indicate that maintaining orthostatic homeostasis might be an effective strategy for the prevention of cognitive decline in the patients.
Funding
- Government Support - Non-U.S.