Department of Internal Medicine, Inje University College of Medicine, Busan, South Korea.
Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Ren Fail. 2024 Dec;46(2):2387426. doi: 10.1080/0886022X.2024.2387426. Epub 2024 Aug 13.
End-stage kidney disease (ESKD) patients undergoing hemodialysis experience diverse neurological complications. This study investigated prefrontal cerebral blood volume (CBV) and cerebral blood flow (CBF) during hemodialysis using functional near-infrared spectroscopy (fNIRS) to analyze cerebral hemodynamic changes.
ESKD patients undergoing maintenance hemodialysis without a history of neurological disorders were enrolled prospectively. The fNIRS data were collected using a NIRSIT Lite device. The fNIRS values were recorded three times for each patient: before the start of hemodialysis (pre-HD), 1 h after the start of hemodialysis (mid-HD), and after the end of hemodialysis (post-HD). The average changes in oxy-hemoglobin (HbO), deoxy-hemoglobin (HbR), total hemoglobin (HbT, calculated as HbO + HbR) concentrations, and in hemoglobin concentration difference (HbD, calculated as HbO - HbR) were analyzed. We then compared the differences in changes in HbO, HbR, HbT, and HbD according to the hemodialysis period.
Thirty hemodialysis patients were analyzed. The change in HbO, HbT, and HbD levels showed significant differences according to the hemodialysis period. Between the pre-HD and post-HD periods, there were significant differences in changes in HbO (0.005 ± 0.001 µM vs. 0.015 ± 0.004 µM, = .046) and HbT (0.006 ± 0.001 µM vs. 0.016 ± 0.008 µM, = .029). Additionally, between pre-HD and post-HD periods, HbD tended to increase (0.005 ± 0.001 µM vs. 0.014 ± 0.004 µM, = .094).
We demonstrated that during one hemodialysis session, the relative change in prefrontal CBV increased post-HD compared with pre-HD. These results are expected to help understanding the mechanisms underlying the effects of hemodialysis on brain function.
接受血液透析的终末期肾病（ESKD）患者会经历多种神经并发症。本研究使用功能近红外光谱（fNIRS）来研究透析过程中前额叶脑血容量（CBV）和脑血流（CBF），以分析脑血流动力学的变化。
前瞻性纳入无神经障碍病史的接受维持性血液透析的 ESKD 患者。使用 NIRSIT Lite 设备采集 fNIRS 数据。每位患者记录 3 次 fNIRS 值：血液透析前（pre-HD）、血液透析开始后 1 小时（mid-HD）和血液透析结束后（post-HD）。分析氧合血红蛋白（HbO）、脱氧血红蛋白（HbR）、总血红蛋白（HbT，HbO+HbR）浓度和血红蛋白浓度差（HbD，HbO-HbR）的平均变化。然后，我们比较了根据血液透析期不同，HbO、HbR、HbT 和 HbD 的变化差异。
分析了 30 名血液透析患者。HbO、HbT 和 HbD 水平的变化根据血液透析期呈现出显著差异。与 pre-HD 相比，post-HD 时 HbO（0.005±0.001 μM 比 0.015±0.004 μM，=0.046）和 HbT（0.006±0.001 μM 比 0.016±0.008 μM，=0.029）的变化差异有统计学意义。此外，HbD 在 pre-HD 与 post-HD 期间有增加的趋势（0.005±0.001 μM 比 0.014±0.004 μM，=0.094）。
本研究表明，在一次血液透析过程中，与 pre-HD 相比，post-HD 时前额叶 CBV 的相对变化增加。这些结果有望帮助理解血液透析对大脑功能影响的作用机制。
