Brain atrophy in peritoneal dialysis and CKD stages 3-5: A cross-sectional and longitudinal study

Kazuhiko Tsuruya, Hisako Yoshida, Yusuke Kuroki, Masaharu Nagata, Tohru Mizumasa, Koji Mitsuiki, Takashi Yoshiura, Makoto Hirakawa, Hidetoshi Kanai, Kei Hori, Hideki Hirakata, Takanari Kitazono

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background Brain atrophy has been reported in patients with end-stage renal disease receiving hemodialysis, although its mechanism is unknown. However, little is known regarding brain atrophy in patients receiving peritoneal dialysis (PD). Therefore, we examined brain volume and its annual change over 2 years in PD patients compared with patients with non-dialysis-dependent chronic kidney disease (NDD-CKD). Study Design Cross-sectional and longitudinal cohort. Setting & Participants 62 PD patients and 69 patients with NDD-CKD with no history of cerebrovascular disease who underwent brain magnetic resonance imaging (MRI) were recruited in a cross-sectional study. Among them, 34 PD patients and 61 patients with NDD-CKD, who underwent a second brain MRI after 2 years, were recruited in a longitudinal study. Predictor PD therapy versus NDD-CKD. Outcomes & Measurements T1-weighted magnetic resonance images were analyzed. Total gray matter volume (GMV), total white matter volume (WMV), and cerebrospinal fluid space volume were segmented, and each volume was quantified using statistical parametric mapping software. Normalized GMV and WMV values were calculated by division of GMV and WMV by intracranial volume to adjust for variations in head size. We compared normalized GMV and normalized WMV between PD patients and patients with NDD-CKD in the cross-sectional study and the annual change in normalized GMV in the longitudinal study. Results In the cross-sectional study, normalized GMV, which was correlated inversely with age, was lower in PD patients than in patients with NDD-CKD. However, normalized WMV, which was not correlated with age, was comparable between the groups. Annual change in normalized GMV was significantly higher in PD patients than in patients with NDD-CKD. These differences remained significant even after adjustment for potential confounding factors. Limitations A short observation period and high dropout rate in the longitudinal study. Conclusions Decline in normalized GMV is faster in PD patients than in patients with NDD-CKD.

Original languageEnglish
Pages (from-to)312-321
Number of pages10
JournalAmerican Journal of Kidney Diseases
Volume65
Issue number2
DOIs
Publication statusPublished - Feb 1 2015

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Peritoneal Dialysis
Atrophy
Longitudinal Studies
Cross-Sectional Studies
Brain
Chronic Renal Insufficiency
Magnetic Resonance Imaging
Cerebrovascular Disorders
Gray Matter
Chronic Kidney Failure
Cerebrospinal Fluid
Renal Dialysis

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Brain atrophy in peritoneal dialysis and CKD stages 3-5 : A cross-sectional and longitudinal study. / Tsuruya, Kazuhiko; Yoshida, Hisako; Kuroki, Yusuke; Nagata, Masaharu; Mizumasa, Tohru; Mitsuiki, Koji; Yoshiura, Takashi; Hirakawa, Makoto; Kanai, Hidetoshi; Hori, Kei; Hirakata, Hideki; Kitazono, Takanari.

In: American Journal of Kidney Diseases, Vol. 65, No. 2, 01.02.2015, p. 312-321.

Research output: Contribution to journalArticle

Tsuruya, K, Yoshida, H, Kuroki, Y, Nagata, M, Mizumasa, T, Mitsuiki, K, Yoshiura, T, Hirakawa, M, Kanai, H, Hori, K, Hirakata, H & Kitazono, T 2015, 'Brain atrophy in peritoneal dialysis and CKD stages 3-5: A cross-sectional and longitudinal study', American Journal of Kidney Diseases, vol. 65, no. 2, pp. 312-321. https://doi.org/10.1053/j.ajkd.2014.07.011
Tsuruya, Kazuhiko ; Yoshida, Hisako ; Kuroki, Yusuke ; Nagata, Masaharu ; Mizumasa, Tohru ; Mitsuiki, Koji ; Yoshiura, Takashi ; Hirakawa, Makoto ; Kanai, Hidetoshi ; Hori, Kei ; Hirakata, Hideki ; Kitazono, Takanari. / Brain atrophy in peritoneal dialysis and CKD stages 3-5 : A cross-sectional and longitudinal study. In: American Journal of Kidney Diseases. 2015 ; Vol. 65, No. 2. pp. 312-321.
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abstract = "Background Brain atrophy has been reported in patients with end-stage renal disease receiving hemodialysis, although its mechanism is unknown. However, little is known regarding brain atrophy in patients receiving peritoneal dialysis (PD). Therefore, we examined brain volume and its annual change over 2 years in PD patients compared with patients with non-dialysis-dependent chronic kidney disease (NDD-CKD). Study Design Cross-sectional and longitudinal cohort. Setting & Participants 62 PD patients and 69 patients with NDD-CKD with no history of cerebrovascular disease who underwent brain magnetic resonance imaging (MRI) were recruited in a cross-sectional study. Among them, 34 PD patients and 61 patients with NDD-CKD, who underwent a second brain MRI after 2 years, were recruited in a longitudinal study. Predictor PD therapy versus NDD-CKD. Outcomes & Measurements T1-weighted magnetic resonance images were analyzed. Total gray matter volume (GMV), total white matter volume (WMV), and cerebrospinal fluid space volume were segmented, and each volume was quantified using statistical parametric mapping software. Normalized GMV and WMV values were calculated by division of GMV and WMV by intracranial volume to adjust for variations in head size. We compared normalized GMV and normalized WMV between PD patients and patients with NDD-CKD in the cross-sectional study and the annual change in normalized GMV in the longitudinal study. Results In the cross-sectional study, normalized GMV, which was correlated inversely with age, was lower in PD patients than in patients with NDD-CKD. However, normalized WMV, which was not correlated with age, was comparable between the groups. Annual change in normalized GMV was significantly higher in PD patients than in patients with NDD-CKD. These differences remained significant even after adjustment for potential confounding factors. Limitations A short observation period and high dropout rate in the longitudinal study. Conclusions Decline in normalized GMV is faster in PD patients than in patients with NDD-CKD.",
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T1 - Brain atrophy in peritoneal dialysis and CKD stages 3-5

T2 - A cross-sectional and longitudinal study

AU - Tsuruya, Kazuhiko

AU - Yoshida, Hisako

AU - Kuroki, Yusuke

AU - Nagata, Masaharu

AU - Mizumasa, Tohru

AU - Mitsuiki, Koji

AU - Yoshiura, Takashi

AU - Hirakawa, Makoto

AU - Kanai, Hidetoshi

AU - Hori, Kei

AU - Hirakata, Hideki

AU - Kitazono, Takanari

PY - 2015/2/1

Y1 - 2015/2/1

N2 - Background Brain atrophy has been reported in patients with end-stage renal disease receiving hemodialysis, although its mechanism is unknown. However, little is known regarding brain atrophy in patients receiving peritoneal dialysis (PD). Therefore, we examined brain volume and its annual change over 2 years in PD patients compared with patients with non-dialysis-dependent chronic kidney disease (NDD-CKD). Study Design Cross-sectional and longitudinal cohort. Setting & Participants 62 PD patients and 69 patients with NDD-CKD with no history of cerebrovascular disease who underwent brain magnetic resonance imaging (MRI) were recruited in a cross-sectional study. Among them, 34 PD patients and 61 patients with NDD-CKD, who underwent a second brain MRI after 2 years, were recruited in a longitudinal study. Predictor PD therapy versus NDD-CKD. Outcomes & Measurements T1-weighted magnetic resonance images were analyzed. Total gray matter volume (GMV), total white matter volume (WMV), and cerebrospinal fluid space volume were segmented, and each volume was quantified using statistical parametric mapping software. Normalized GMV and WMV values were calculated by division of GMV and WMV by intracranial volume to adjust for variations in head size. We compared normalized GMV and normalized WMV between PD patients and patients with NDD-CKD in the cross-sectional study and the annual change in normalized GMV in the longitudinal study. Results In the cross-sectional study, normalized GMV, which was correlated inversely with age, was lower in PD patients than in patients with NDD-CKD. However, normalized WMV, which was not correlated with age, was comparable between the groups. Annual change in normalized GMV was significantly higher in PD patients than in patients with NDD-CKD. These differences remained significant even after adjustment for potential confounding factors. Limitations A short observation period and high dropout rate in the longitudinal study. Conclusions Decline in normalized GMV is faster in PD patients than in patients with NDD-CKD.

AB - Background Brain atrophy has been reported in patients with end-stage renal disease receiving hemodialysis, although its mechanism is unknown. However, little is known regarding brain atrophy in patients receiving peritoneal dialysis (PD). Therefore, we examined brain volume and its annual change over 2 years in PD patients compared with patients with non-dialysis-dependent chronic kidney disease (NDD-CKD). Study Design Cross-sectional and longitudinal cohort. Setting & Participants 62 PD patients and 69 patients with NDD-CKD with no history of cerebrovascular disease who underwent brain magnetic resonance imaging (MRI) were recruited in a cross-sectional study. Among them, 34 PD patients and 61 patients with NDD-CKD, who underwent a second brain MRI after 2 years, were recruited in a longitudinal study. Predictor PD therapy versus NDD-CKD. Outcomes & Measurements T1-weighted magnetic resonance images were analyzed. Total gray matter volume (GMV), total white matter volume (WMV), and cerebrospinal fluid space volume were segmented, and each volume was quantified using statistical parametric mapping software. Normalized GMV and WMV values were calculated by division of GMV and WMV by intracranial volume to adjust for variations in head size. We compared normalized GMV and normalized WMV between PD patients and patients with NDD-CKD in the cross-sectional study and the annual change in normalized GMV in the longitudinal study. Results In the cross-sectional study, normalized GMV, which was correlated inversely with age, was lower in PD patients than in patients with NDD-CKD. However, normalized WMV, which was not correlated with age, was comparable between the groups. Annual change in normalized GMV was significantly higher in PD patients than in patients with NDD-CKD. These differences remained significant even after adjustment for potential confounding factors. Limitations A short observation period and high dropout rate in the longitudinal study. Conclusions Decline in normalized GMV is faster in PD patients than in patients with NDD-CKD.

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