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논문분류	춘계학술대회 초록집
제목	Effect of hemodialysis on changes in cerebral blood flow in patients with end-stage renal disease: a functional near-infrared spectroscopy study
저자	Yeongrok Oh
출판정보	2023; 2023(1):
키워드
초록	Objectives: The relationship between hemodialysis and changes in cerebral blood flow change in patients with endstage renal disease (ESRD) is complex and not fully understood. This study aimed to investigate changes in cerebral blood flow in patients with ESRD undergoing hemodialysis using functional nearinfrared spectroscopy (fNIRS) and to analyze the effect of hemodialysis on changes in cerebral blood flow. Methods: We prospectively enrolled patients with ESRD undergoing hemodialysis over six months without any history of neurological disorders. fNIRS estimates brain cortical hemodynamic activity by measuring changes of oxy- and deoxy-hemoglobin concentrations using the different absorption rate of near-infrared light. During a single hemodialysis session, every patient took fNIRS 3 times; before the start of hemodialysis (pre-HD), one hour after the start of hemodialysis (mid-HD), and after the end of hemodialysis (postHD). Then, we compared the values of fNIRS within each patient. Results: The thirty patients were analyzed. The mean age of the patients was 69 years and the mean dialysis vintage was 52 months. The twenty-one patients (70%) were male and the seventeen patients (56.7%) had diabetes. There were no changes with mean blood pressure during dialysis (93.8 ± 10.8 mmHg in pre-HD, 91.2 ± 13.0 mmHg in mid-HD, and 95.2 ± 14.7 mmHg in post-HD). There was significant difference in changes with total hemoglobin concentrations (oxy & deoxy-hemoglobin) between the pre- and post-HD periods (0.006 ± 0.006 vs 0.015 ± 0.019, p=0.029). However, there were no statistical differences between others. Conclusions: We demonstrated the significant changes of cerebral blood flow during hemodialysis by non-invasive neuroimaging technique. After the end of dialysis, the cerebral blood flow was improved compared to at the beginning of dialysis. The removal of uremic toxins, rather than hemodynamic change, might have positive effects on brain circulating or glymphatic systems.
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