Morphological study of ESRD patients before hemodialysis initiation based on SBM analysis / 西安交通大学学报(医学版)

ABSTRACT

Objective: To explore the potential clinical risk factors related to abnormal microstructure of brain gray matter in end-stage renal disease (ESRD) patients with cognitive dysfunction. Methods: 3D high-resolution structural imaging was applied in 34 ESRD patients before hemodialysis and 34 health controls. We analyzed the characteristics of changes in gray matter cortical thickness in patients with ESRD before the first dialysis by surface based morphology (SBM) analysis. Further Pearson correlation analysis was used to reveal the relationship of the changed cortical thickness with the laboratory test indicators and clinical scale scores in patient group, with the covariants of age, sex and education removed. Results: Compared with that in control group, the broad cortex thickness decreases were observed in patients with ESRD before the first dialysis (P<0.01, FDR corrected), mainly including the bilateral postcentral gyrus, bilateral precentral gyrus, bilateral inferior parietal lobe (IPL), bilateral precuneus and some frontal and temporal lobes. Pearson correlation analysis showed that the cortical thickness in the IPL and precuneus had significantly negative correlation with uric acid level (r=-0.543, P<0.01) and the decreased thickness of bilateral IPL was positively related to AVL-IR score (right r=0.522, left r=0.649, P<0.01). Conclusion: ESRD patients showed extensive cortical thickness reduction before dialysis initiation, which corrected with overall cognition and immediate memory dysfunction. High uric acid level was the major factor of morphlolgical changes in ESRD patients before dialysis initiation.