Dialysis-related hypotension as a cause of progressive frontal lobe atrophy in chronic hemodialysis patients: A 3-year prospective study

Tohru Mizumasa, Hideki Hirakata, Takahiro Yoshimitsu, Eriko Hirakata, Michiaki Kubo, Minoru Kashiwagi, Hiroshi Tanaka, Hidetoshi Kanai, Satoru Fujimi, Mitsuo Iida

Research output: Contribution to journalArticle

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Abstract

Background/Aim: Brain atrophy is known to develop more rapidly in hemodialysis (HD) patients than other individuals. The present study was designed to examine the role of HD-related hypotension in brain atrophy in patients on chronic HD. Methods: By using magnetic resonance imaging, whole brain atrophy was assessed by the ventricular-brain ratio (VBR; ventricular area/whole brain area). Frontal brain atrophy was assessed by the frontal atrophy index (FAI; frontal brain area/intracranial frontal space). The number of lacunae was also counted. We studied 32 HD patients without symptomatic neurological abnormalities or diabetes mellitus: male/female ratio 19/13; mean age ± SD 53 ± 10 (range 28-77) years; mean HD duration ± SD 11 ± 6 (range 1-22) years. Magnetic resonance imagings were taken in 1995 and 1998. All dialysis-related hypotension episodes during the same period were identified from the medical records and counted. Results: The VBR ranged from 8.8 to 18.7% in 1995 (12.8 ± 2.2%) and was not different in 1998 (13.1 ± 2.7%). However, the VBR increased by more than 5% in 14 patients, and their HD duration of 13 ± 6 years was significantly longer than that of 18 patients with stable VBR (p < 0.05). The FAI in 1995 was 62.2 ± 4.2% (range 55.8-71.3%) and decreased significantly to 59.7 ± 4.7% (range 50.2-70.9%) in 1998 (p < 0.05). The change in FAI correlated significantly with both the total number of dialysis-related hypotension episodes (r = 0.45, p < 0.05) and the increase in number of lacunae (r = 0.42, p < 0.05). Conclusion: Our results suggest that dialysis-related hypotension plays a role in progressive frontal lobe atrophy in HD patients.

Original languageEnglish
JournalNephron - Clinical Practice
Volume97
Issue number1
DOIs
Publication statusPublished - 15-06-2004
Externally publishedYes

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Frontal Lobe
Hypotension
Atrophy
Renal Dialysis
Dialysis
Prospective Studies
Brain
Magnetic Resonance Imaging
Medical Records
Diabetes Mellitus

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Mizumasa, Tohru ; Hirakata, Hideki ; Yoshimitsu, Takahiro ; Hirakata, Eriko ; Kubo, Michiaki ; Kashiwagi, Minoru ; Tanaka, Hiroshi ; Kanai, Hidetoshi ; Fujimi, Satoru ; Iida, Mitsuo. / Dialysis-related hypotension as a cause of progressive frontal lobe atrophy in chronic hemodialysis patients : A 3-year prospective study. In: Nephron - Clinical Practice. 2004 ; Vol. 97, No. 1.
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title = "Dialysis-related hypotension as a cause of progressive frontal lobe atrophy in chronic hemodialysis patients: A 3-year prospective study",
abstract = "Background/Aim: Brain atrophy is known to develop more rapidly in hemodialysis (HD) patients than other individuals. The present study was designed to examine the role of HD-related hypotension in brain atrophy in patients on chronic HD. Methods: By using magnetic resonance imaging, whole brain atrophy was assessed by the ventricular-brain ratio (VBR; ventricular area/whole brain area). Frontal brain atrophy was assessed by the frontal atrophy index (FAI; frontal brain area/intracranial frontal space). The number of lacunae was also counted. We studied 32 HD patients without symptomatic neurological abnormalities or diabetes mellitus: male/female ratio 19/13; mean age ± SD 53 ± 10 (range 28-77) years; mean HD duration ± SD 11 ± 6 (range 1-22) years. Magnetic resonance imagings were taken in 1995 and 1998. All dialysis-related hypotension episodes during the same period were identified from the medical records and counted. Results: The VBR ranged from 8.8 to 18.7{\%} in 1995 (12.8 ± 2.2{\%}) and was not different in 1998 (13.1 ± 2.7{\%}). However, the VBR increased by more than 5{\%} in 14 patients, and their HD duration of 13 ± 6 years was significantly longer than that of 18 patients with stable VBR (p < 0.05). The FAI in 1995 was 62.2 ± 4.2{\%} (range 55.8-71.3{\%}) and decreased significantly to 59.7 ± 4.7{\%} (range 50.2-70.9{\%}) in 1998 (p < 0.05). The change in FAI correlated significantly with both the total number of dialysis-related hypotension episodes (r = 0.45, p < 0.05) and the increase in number of lacunae (r = 0.42, p < 0.05). Conclusion: Our results suggest that dialysis-related hypotension plays a role in progressive frontal lobe atrophy in HD patients.",
author = "Tohru Mizumasa and Hideki Hirakata and Takahiro Yoshimitsu and Eriko Hirakata and Michiaki Kubo and Minoru Kashiwagi and Hiroshi Tanaka and Hidetoshi Kanai and Satoru Fujimi and Mitsuo Iida",
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Mizumasa, T, Hirakata, H, Yoshimitsu, T, Hirakata, E, Kubo, M, Kashiwagi, M, Tanaka, H, Kanai, H, Fujimi, S & Iida, M 2004, 'Dialysis-related hypotension as a cause of progressive frontal lobe atrophy in chronic hemodialysis patients: A 3-year prospective study', Nephron - Clinical Practice, vol. 97, no. 1. https://doi.org/10.1159/000077592

Dialysis-related hypotension as a cause of progressive frontal lobe atrophy in chronic hemodialysis patients : A 3-year prospective study. / Mizumasa, Tohru; Hirakata, Hideki; Yoshimitsu, Takahiro; Hirakata, Eriko; Kubo, Michiaki; Kashiwagi, Minoru; Tanaka, Hiroshi; Kanai, Hidetoshi; Fujimi, Satoru; Iida, Mitsuo.

In: Nephron - Clinical Practice, Vol. 97, No. 1, 15.06.2004.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Dialysis-related hypotension as a cause of progressive frontal lobe atrophy in chronic hemodialysis patients

T2 - A 3-year prospective study

AU - Mizumasa, Tohru

AU - Hirakata, Hideki

AU - Yoshimitsu, Takahiro

AU - Hirakata, Eriko

AU - Kubo, Michiaki

AU - Kashiwagi, Minoru

AU - Tanaka, Hiroshi

AU - Kanai, Hidetoshi

AU - Fujimi, Satoru

AU - Iida, Mitsuo

PY - 2004/6/15

Y1 - 2004/6/15

N2 - Background/Aim: Brain atrophy is known to develop more rapidly in hemodialysis (HD) patients than other individuals. The present study was designed to examine the role of HD-related hypotension in brain atrophy in patients on chronic HD. Methods: By using magnetic resonance imaging, whole brain atrophy was assessed by the ventricular-brain ratio (VBR; ventricular area/whole brain area). Frontal brain atrophy was assessed by the frontal atrophy index (FAI; frontal brain area/intracranial frontal space). The number of lacunae was also counted. We studied 32 HD patients without symptomatic neurological abnormalities or diabetes mellitus: male/female ratio 19/13; mean age ± SD 53 ± 10 (range 28-77) years; mean HD duration ± SD 11 ± 6 (range 1-22) years. Magnetic resonance imagings were taken in 1995 and 1998. All dialysis-related hypotension episodes during the same period were identified from the medical records and counted. Results: The VBR ranged from 8.8 to 18.7% in 1995 (12.8 ± 2.2%) and was not different in 1998 (13.1 ± 2.7%). However, the VBR increased by more than 5% in 14 patients, and their HD duration of 13 ± 6 years was significantly longer than that of 18 patients with stable VBR (p < 0.05). The FAI in 1995 was 62.2 ± 4.2% (range 55.8-71.3%) and decreased significantly to 59.7 ± 4.7% (range 50.2-70.9%) in 1998 (p < 0.05). The change in FAI correlated significantly with both the total number of dialysis-related hypotension episodes (r = 0.45, p < 0.05) and the increase in number of lacunae (r = 0.42, p < 0.05). Conclusion: Our results suggest that dialysis-related hypotension plays a role in progressive frontal lobe atrophy in HD patients.

AB - Background/Aim: Brain atrophy is known to develop more rapidly in hemodialysis (HD) patients than other individuals. The present study was designed to examine the role of HD-related hypotension in brain atrophy in patients on chronic HD. Methods: By using magnetic resonance imaging, whole brain atrophy was assessed by the ventricular-brain ratio (VBR; ventricular area/whole brain area). Frontal brain atrophy was assessed by the frontal atrophy index (FAI; frontal brain area/intracranial frontal space). The number of lacunae was also counted. We studied 32 HD patients without symptomatic neurological abnormalities or diabetes mellitus: male/female ratio 19/13; mean age ± SD 53 ± 10 (range 28-77) years; mean HD duration ± SD 11 ± 6 (range 1-22) years. Magnetic resonance imagings were taken in 1995 and 1998. All dialysis-related hypotension episodes during the same period were identified from the medical records and counted. Results: The VBR ranged from 8.8 to 18.7% in 1995 (12.8 ± 2.2%) and was not different in 1998 (13.1 ± 2.7%). However, the VBR increased by more than 5% in 14 patients, and their HD duration of 13 ± 6 years was significantly longer than that of 18 patients with stable VBR (p < 0.05). The FAI in 1995 was 62.2 ± 4.2% (range 55.8-71.3%) and decreased significantly to 59.7 ± 4.7% (range 50.2-70.9%) in 1998 (p < 0.05). The change in FAI correlated significantly with both the total number of dialysis-related hypotension episodes (r = 0.45, p < 0.05) and the increase in number of lacunae (r = 0.42, p < 0.05). Conclusion: Our results suggest that dialysis-related hypotension plays a role in progressive frontal lobe atrophy in HD patients.

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