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Kidney Week

Abstract: SA-PO547

Changes in the Glymphatic System Before and After Dialysis Initiation in Patients with ESRD

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Yi, Jiyae, Inje University Haeundae Paik Hospital, Busan, Korea (the Republic of)
  • Park, Sihyung, Inje University Haeundae Paik Hospital, Busan, Korea (the Republic of)
  • Kim, Yang Wook, Inje University Haeundae Paik Hospital, Busan, Korea (the Republic of)
  • Park, Bongsoo, Inje University Haeundae Paik Hospital, Busan, Korea (the Republic of)
  • Lee, Yoo jin, Inje University Haeundae Paik Hospital, Busan, Korea (the Republic of)
  • Heo, Changmin, Inje University Haeundae Paik Hospital, Busan, Korea (the Republic of)
  • Oh, Yeongrok, Inje University Haeundae Paik Hospital, Busan, Korea (the Republic of)
  • Choi, Byeongo, Inje University Haeundae Paik Hospital, Busan, Korea (the Republic of)
Background

This study evaluated 1) glymphatic system function in patients with end-stage renal disease (ESRD) before dialysis initiation compared to healthy controls, and 2) changes in glymphatic system function after renal replacement therapy including dialysis in patients with ESRD using the diffusion tensor image analysis along the perivascular space (DTI-ALPS) method.

Methods

This prospective study was conducted at a single hospital. We enrolled 14 neurologically asymptomatic patients who initiated hemodialysis or peritoneal dialysis for ESRD, as well as 17 healthy controls. The patients underwent magnetic resonance imaging (MRI) before and 3 months after dialysis initiation, and the DTI-ALPS index was calculated. We compared the DTI-ALPS index before and after dialysis initiation between patients with ESRD and healthy controls.

Results

The DTI-ALPS index differed between patients with ESRD before dialysis initiation and healthy controls (1.342 vs. 1.633, p=0.003) but not between patients with ESRD before and after dialysis initiation (1.342 vs. 1.262, p=0.386). A positive correlation was observed between DTI-ALPS and phosphate levels (r=0.610, p=0.020) in patients with ESRD.

Conclusion

We confirmed glymphatic dysfunction in patients with ESRD but observed no differences before or after dialysis initiation. This may be related to uremic toxins that are not removed by dialysis in patients with ESRD. The results of this study could be used to develop the pathophysiology and treatment of patients with ESRD.