Cerebral ischemia as a causative mechanism for rapid progression of brain atrophy in chronic hemodialysis patients

T. Yoshimitsu, H. Hirakata, K. Fujii, H. Kanai, E. Hirakata, H. Higashi, M. Kubo, H. Tanaka, M. Shinozaki, R. Katafuchi, Y. Yokomizo, Y. Oh, S. Tomooka, S. Fujimi, M. Fujishima

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: It has been found that brain atrophy develops more rapidly in patients with end-stage renal failure after initiation of dialysis therapy. The present study was designed to analyze the relationship between brain atrophy and asymptomatic ischemic brain lesions. Patients and methods: Magnetic resonance imaging (MRI) was performed for the evaluation of brain atrophy and ischemic lesions. Brain atrophy was assessed by the ventricular- brain ratio (VBR), calculated as the ratio of the ventricular area to the whole brain area on the maximum MRI slice. The severity of periventricular hyperintensity (PVH) and the number of lacunae were also regarded as ischemic brain lesions. Fifty-five patients undergoing maintenance hemodialysis (HD) without clinically overt neurological signs and symptoms, with a mean age of 52 ± 11 (SD) years and a mean HD duration of 7 ± 6 (SD) years were subjected. VBR and its relationship to ischemic brain lesion data were compared to those in 35 non-HD patients (controls), with a mean age of 42 ± 14 (SD) years. Results: The VBR, the number of lacunae and the severity of PVH tended to increase with age in HD. The VBRs at all age groups were significantly higher in HD than in controls (7.0 vs 3.7% at the 4th decade, p < 0.05; 8.4 vs 5.9% at the 5th decade, p < 0.05; 9.6 vs 5.4% at the 6th decade, p < 0.05; and 11.6 vs 6.3% at the 7th decade, p < 0.05). HD patients had significantly higher number of lacunae and had more advanced PVH than did controls. Both the number of lacunae and the severity of PVH were significantly correlated to VBR in HD. Conclusion: In conclusion, the rapid progression of brain atrophy was related to the asymptomatic ischemic brain lesions in our HD patients. Such data indicated that cerebral ischemia might be a causative mechanism of brain atrophy in chronic hemodialysis patients.

Original languageEnglish
Pages (from-to)445-451
Number of pages7
JournalClinical nephrology
Volume53
Issue number6
Publication statusPublished - 30-06-2000

Fingerprint

Brain Ischemia
Atrophy
Renal Dialysis
Brain
Magnetic Resonance Imaging
Signs and Symptoms
Chronic Kidney Failure
Dialysis
Age Groups

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Yoshimitsu, T., Hirakata, H., Fujii, K., Kanai, H., Hirakata, E., Higashi, H., ... Fujishima, M. (2000). Cerebral ischemia as a causative mechanism for rapid progression of brain atrophy in chronic hemodialysis patients. Clinical nephrology, 53(6), 445-451.
Yoshimitsu, T. ; Hirakata, H. ; Fujii, K. ; Kanai, H. ; Hirakata, E. ; Higashi, H. ; Kubo, M. ; Tanaka, H. ; Shinozaki, M. ; Katafuchi, R. ; Yokomizo, Y. ; Oh, Y. ; Tomooka, S. ; Fujimi, S. ; Fujishima, M. / Cerebral ischemia as a causative mechanism for rapid progression of brain atrophy in chronic hemodialysis patients. In: Clinical nephrology. 2000 ; Vol. 53, No. 6. pp. 445-451.
@article{6219017054fa4d70a9a32ddd03510342,
title = "Cerebral ischemia as a causative mechanism for rapid progression of brain atrophy in chronic hemodialysis patients",
abstract = "Background: It has been found that brain atrophy develops more rapidly in patients with end-stage renal failure after initiation of dialysis therapy. The present study was designed to analyze the relationship between brain atrophy and asymptomatic ischemic brain lesions. Patients and methods: Magnetic resonance imaging (MRI) was performed for the evaluation of brain atrophy and ischemic lesions. Brain atrophy was assessed by the ventricular- brain ratio (VBR), calculated as the ratio of the ventricular area to the whole brain area on the maximum MRI slice. The severity of periventricular hyperintensity (PVH) and the number of lacunae were also regarded as ischemic brain lesions. Fifty-five patients undergoing maintenance hemodialysis (HD) without clinically overt neurological signs and symptoms, with a mean age of 52 ± 11 (SD) years and a mean HD duration of 7 ± 6 (SD) years were subjected. VBR and its relationship to ischemic brain lesion data were compared to those in 35 non-HD patients (controls), with a mean age of 42 ± 14 (SD) years. Results: The VBR, the number of lacunae and the severity of PVH tended to increase with age in HD. The VBRs at all age groups were significantly higher in HD than in controls (7.0 vs 3.7{\%} at the 4th decade, p < 0.05; 8.4 vs 5.9{\%} at the 5th decade, p < 0.05; 9.6 vs 5.4{\%} at the 6th decade, p < 0.05; and 11.6 vs 6.3{\%} at the 7th decade, p < 0.05). HD patients had significantly higher number of lacunae and had more advanced PVH than did controls. Both the number of lacunae and the severity of PVH were significantly correlated to VBR in HD. Conclusion: In conclusion, the rapid progression of brain atrophy was related to the asymptomatic ischemic brain lesions in our HD patients. Such data indicated that cerebral ischemia might be a causative mechanism of brain atrophy in chronic hemodialysis patients.",
author = "T. Yoshimitsu and H. Hirakata and K. Fujii and H. Kanai and E. Hirakata and H. Higashi and M. Kubo and H. Tanaka and M. Shinozaki and R. Katafuchi and Y. Yokomizo and Y. Oh and S. Tomooka and S. Fujimi and M. Fujishima",
year = "2000",
month = "6",
day = "30",
language = "English",
volume = "53",
pages = "445--451",
journal = "Clinical Nephrology",
issn = "0301-0430",
publisher = "Dustri-Verlag Dr. Karl Feistle",
number = "6",

}

Yoshimitsu, T, Hirakata, H, Fujii, K, Kanai, H, Hirakata, E, Higashi, H, Kubo, M, Tanaka, H, Shinozaki, M, Katafuchi, R, Yokomizo, Y, Oh, Y, Tomooka, S, Fujimi, S & Fujishima, M 2000, 'Cerebral ischemia as a causative mechanism for rapid progression of brain atrophy in chronic hemodialysis patients', Clinical nephrology, vol. 53, no. 6, pp. 445-451.

Cerebral ischemia as a causative mechanism for rapid progression of brain atrophy in chronic hemodialysis patients. / Yoshimitsu, T.; Hirakata, H.; Fujii, K.; Kanai, H.; Hirakata, E.; Higashi, H.; Kubo, M.; Tanaka, H.; Shinozaki, M.; Katafuchi, R.; Yokomizo, Y.; Oh, Y.; Tomooka, S.; Fujimi, S.; Fujishima, M.

In: Clinical nephrology, Vol. 53, No. 6, 30.06.2000, p. 445-451.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Cerebral ischemia as a causative mechanism for rapid progression of brain atrophy in chronic hemodialysis patients

AU - Yoshimitsu, T.

AU - Hirakata, H.

AU - Fujii, K.

AU - Kanai, H.

AU - Hirakata, E.

AU - Higashi, H.

AU - Kubo, M.

AU - Tanaka, H.

AU - Shinozaki, M.

AU - Katafuchi, R.

AU - Yokomizo, Y.

AU - Oh, Y.

AU - Tomooka, S.

AU - Fujimi, S.

AU - Fujishima, M.

PY - 2000/6/30

Y1 - 2000/6/30

N2 - Background: It has been found that brain atrophy develops more rapidly in patients with end-stage renal failure after initiation of dialysis therapy. The present study was designed to analyze the relationship between brain atrophy and asymptomatic ischemic brain lesions. Patients and methods: Magnetic resonance imaging (MRI) was performed for the evaluation of brain atrophy and ischemic lesions. Brain atrophy was assessed by the ventricular- brain ratio (VBR), calculated as the ratio of the ventricular area to the whole brain area on the maximum MRI slice. The severity of periventricular hyperintensity (PVH) and the number of lacunae were also regarded as ischemic brain lesions. Fifty-five patients undergoing maintenance hemodialysis (HD) without clinically overt neurological signs and symptoms, with a mean age of 52 ± 11 (SD) years and a mean HD duration of 7 ± 6 (SD) years were subjected. VBR and its relationship to ischemic brain lesion data were compared to those in 35 non-HD patients (controls), with a mean age of 42 ± 14 (SD) years. Results: The VBR, the number of lacunae and the severity of PVH tended to increase with age in HD. The VBRs at all age groups were significantly higher in HD than in controls (7.0 vs 3.7% at the 4th decade, p < 0.05; 8.4 vs 5.9% at the 5th decade, p < 0.05; 9.6 vs 5.4% at the 6th decade, p < 0.05; and 11.6 vs 6.3% at the 7th decade, p < 0.05). HD patients had significantly higher number of lacunae and had more advanced PVH than did controls. Both the number of lacunae and the severity of PVH were significantly correlated to VBR in HD. Conclusion: In conclusion, the rapid progression of brain atrophy was related to the asymptomatic ischemic brain lesions in our HD patients. Such data indicated that cerebral ischemia might be a causative mechanism of brain atrophy in chronic hemodialysis patients.

AB - Background: It has been found that brain atrophy develops more rapidly in patients with end-stage renal failure after initiation of dialysis therapy. The present study was designed to analyze the relationship between brain atrophy and asymptomatic ischemic brain lesions. Patients and methods: Magnetic resonance imaging (MRI) was performed for the evaluation of brain atrophy and ischemic lesions. Brain atrophy was assessed by the ventricular- brain ratio (VBR), calculated as the ratio of the ventricular area to the whole brain area on the maximum MRI slice. The severity of periventricular hyperintensity (PVH) and the number of lacunae were also regarded as ischemic brain lesions. Fifty-five patients undergoing maintenance hemodialysis (HD) without clinically overt neurological signs and symptoms, with a mean age of 52 ± 11 (SD) years and a mean HD duration of 7 ± 6 (SD) years were subjected. VBR and its relationship to ischemic brain lesion data were compared to those in 35 non-HD patients (controls), with a mean age of 42 ± 14 (SD) years. Results: The VBR, the number of lacunae and the severity of PVH tended to increase with age in HD. The VBRs at all age groups were significantly higher in HD than in controls (7.0 vs 3.7% at the 4th decade, p < 0.05; 8.4 vs 5.9% at the 5th decade, p < 0.05; 9.6 vs 5.4% at the 6th decade, p < 0.05; and 11.6 vs 6.3% at the 7th decade, p < 0.05). HD patients had significantly higher number of lacunae and had more advanced PVH than did controls. Both the number of lacunae and the severity of PVH were significantly correlated to VBR in HD. Conclusion: In conclusion, the rapid progression of brain atrophy was related to the asymptomatic ischemic brain lesions in our HD patients. Such data indicated that cerebral ischemia might be a causative mechanism of brain atrophy in chronic hemodialysis patients.

UR - http://www.scopus.com/inward/record.url?scp=18844472122&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=18844472122&partnerID=8YFLogxK

M3 - Article

C2 - 10879664

AN - SCOPUS:18844472122

VL - 53

SP - 445

EP - 451

JO - Clinical Nephrology

JF - Clinical Nephrology

SN - 0301-0430

IS - 6

ER -

Yoshimitsu T, Hirakata H, Fujii K, Kanai H, Hirakata E, Higashi H et al. Cerebral ischemia as a causative mechanism for rapid progression of brain atrophy in chronic hemodialysis patients. Clinical nephrology. 2000 Jun 30;53(6):445-451.