Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
J Cereb Blood Flow Metab. 2023 Mar;43(3):433-445. doi: 10.1177/0271678X221134384. Epub 2022 Oct 25.
Hemodialysis (HD) is the most regularly applied replacement therapy for end-stage renal disease, but it may result in brain injuries. The correlation between cerebral blood flow (CBF) alteration and iron deposition has not been investigated in patients undergoing HD. Ferritin level may be a dominant factor in CBF and iron deposition change. We hypothesize that ferritin level might be the key mediator between iron deposition and CBF alteration. The correlation in the putamen was estimated between the susceptibility values and CBF in patients undergoing HD. Compared with healthy controls, patients showed more altered global susceptibility values and CBF. The susceptibility value was negatively correlated with CBF in the putamen in patients. Moreover, the susceptibility value was negatively correlated with ferritin level and positively correlated with serum iron level in the putamen of patients. CBF was positively correlated with ferritin level and negatively correlated with serum iron level in the putamen of patients. These findings indicate that iron dyshomeostasis and vascular damage might exist in the putamen in patients. The results revealed that iron dyshomeostasis and vascular damage in the putamen may be potential neural mechanisms for neurodegenerative processes in patients undergoing HD.
血液透析(HD)是终末期肾病最常用的替代治疗方法,但它可能导致脑损伤。在接受 HD 的患者中,脑血流量(CBF)改变与铁沉积之间的相关性尚未得到研究。铁蛋白水平可能是 CBF 和铁沉积变化的主要因素。我们假设铁蛋白水平可能是铁沉积和 CBF 改变之间的关键介质。在接受 HD 的患者的壳核中,估计了磁化率值与 CBF 之间的相关性。与健康对照组相比,患者表现出更多的全局磁化率值和 CBF 改变。在患者的壳核中,磁化率值与 CBF 呈负相关。此外,磁化率值与患者壳核中的铁蛋白水平呈负相关,与血清铁水平呈正相关。CBF 与患者壳核中的铁蛋白水平呈正相关,与血清铁水平呈负相关。这些发现表明,铁代谢紊乱和血管损伤可能存在于患者的壳核中。结果表明,壳核中的铁代谢紊乱和血管损伤可能是接受 HD 的患者神经退行性过程的潜在神经机制。