Alterations of amplitude of low-frequency fluctuations and fractional amplitude of low-frequency fluctuations in end-stage renal disease on maintenance dialysis: An activation likelihood estimation meta-analysis

Altered spontaneous brain activity in patients with progressive-stage and end-stage chronic kidney disease: insights from dALFF analysis

Chronic kidney disease (CKD) is a worldwide public health problem. Its association with cognitive impairment has attracted widespread attention in the world. However, the neuropathological mechanisms underlying kidney-brain interactions in CKD remain unclear. Using the dynamic amplitude of low-frequency fluctuations (dALFF) technique, 21 patients with progressive-stage CKD (CKD stages 3-4), 22 patients with end-stage CKD (CKD stage 5, ESKD), and 23 healthy volunteers (HCs) were enrolled to explore the brain regions with dALFF abnormalities in the progressive-stage and end-stage CKD. We used biased correlation analyses to explore the relationship between dALFF values and clinical indicators in patients with progressive-stage and end-stage CKD. Patients with both progressive-stage CKD (stages 3-4) and ESKD had abnormal dALFF values in the right parahippocampus, right inferior temporal gyrus, and left cuneus compared with HCs. In addition, abnormal dALFF were present in the left fusiform gyrus, insula and hippocampus in patients with progressive-stage CKD and in the left inferior temporal gyrus in patients with ESKD. Biased correlation analysis showed that dALFF values in the right parahippocampus, left fusiform gyrus and left insula were positively correlated with serum creatinine concentrations in patients with progressive-stage CKD and that dALFF values in the left inferior temporal gyrus were negatively correlated with MoCA scores in patients with ESKD. Our findings highlight the variability of neuroimaging changes between different stages of CKD and provide new insights and research directions for an in-depth exploration of the neuropathological mechanisms of renal-brain interactions.

Comparison of the effects of peritoneal dialysis and hemodialysis on spontaneous brain activity in CKD patients: an rs-fMRI study

OBJECTIVE

To compare the effects of peritoneal dialysis and hemodialysis on spontaneous brain activity in patients with end-stage renal disease.

METHODS

A total of 52 dialysis patients with end-stage renal disease, including 25 patients with chronic kidney disease undergoing hemodialysis (HD-CKD) and 27 patients with chronic kidney disease undergoing peritoneal dialysis (PD-CKD), and 49 healthy controls (normal control) were included. All participants underwent neuropsychological testing (Mini-Mental State Examination and Montreal cognitive assessment) and resting-state functional magnetic resonance imaging. Fractional amplitude of low frequency fluctuations and Regional Homogeneity algorithms were employed to evaluate spontaneous brain activity. Statistical analysis was performed to discern differences between the groups.

RESULTS

When compared with the normal control group, the PD-CKD group exhibited significant alterations in fractional amplitude of low frequency fluctuations in various cerebellum regions and other brain areas, while the HD-CKD group showed decreased fractional amplitude of low frequency fluctuations in the bilateral pericalcarine cortex. The Regional Homogeneity values in the PD-CKD group were notably different than those in the normal control group, particularly in regions such as the bilateral caudate nucleus and the right putamen.

CONCLUSION

Both peritoneal dialysis and hemodialysis modalities impact brain activity, but manifest differently in end-stage renal disease patients. Understanding these differences is crucial for optimizing patient care.