Abstract:

Objective To investigate the association between cerebral blood flow during hemodialysis and white matter hyperintensities （WMHs） in hemodialysis patients. Methods A total of 105 hemodialysis patients from Beijing Shijitan Hospital were enrolled and divided into the WMHs group （n = 57） and the non-WMHs group （n = 48） based on the presence or absence of white matter hyperintensities. The mean flow velocity （MFV） of the middle cerebral artery during dialysis was measured using transcranial Doppler （TCD）， and the MFV reduction rate was calculated. Clinical data were compared between the two groups. Risk factors for WMHs were analyzed. Moreover， the association between the MFV reduction rate and the severity of WMHs was explored， and the predictive value of the MFV reduction rate for WMHs was evaluated. Results Age， dialysis vintage， and the reduction rate of MFV were significantly higher in the WMHs group compared to the non-WMHs group （P < 0.05）. Multivariate logistic regression analysis indicated that the reduction rate of MFV was an independent risk factor for WMHs （P < 0.05）. Multivariate linear regression analysis demonstrated that the reduction rate of MFV was independently associated with the Fazekas score of WMHs. The area under the curve of the reduction rate of MFV for predicting WMHs was 0.806. Conclusion Cerebral blood flow reduction during hemodialysis is significantly associated with white matter hyperintensities WMHs.

Key words: white matter hyperintensities, renal dialysis, cerebrovascular circulation