Eldehni Mohamed Tarek, McIntyre Christopher W
Semin Dial. 2012 May;25(3):253-6. doi: 10.1111/j.1525-139X.2012.01057.x. Epub 2012 Feb 22.
Structural abnormalities of the brain are common in hemodialysis (HD) patients, as are a wide range of severe functional deficiencies of cerebral function. Both depression and increasing dependency are highly prevalent in HD patients and worsen severely within the first 12 months of dialysis initiation. HD, as it is commonly practiced, is associated with significant recurrent episodes of circulatory stress. This results in acute injury to the heart, skin, kidney and gut, and drives longer term end-organ chronic injury. This article aims to explore the hypothesis that the cerebral microcirculation is also sensitive to dialysis-based circulatory stress (and other multiorgan consequences of recurrent dialysis-induced ischemia), and that this may drive specific patterns of brain injury with resultant psychiatric and functional consequences.
大脑结构异常在血液透析（HD）患者中很常见，大脑功能的一系列严重功能缺陷也是如此。抑郁和依赖性增加在HD患者中都非常普遍，并且在开始透析的头12个月内严重恶化。目前普遍实施的HD与循环应激的显著反复发作有关。这会导致心脏、皮肤、肾脏和肠道的急性损伤，并引发长期的终末器官慢性损伤。本文旨在探讨以下假设：脑微循环也对基于透析的循环应激（以及反复透析引起的缺血的其他多器官后果）敏感，这可能会导致特定的脑损伤模式，从而产生精神和功能后果。
