Structural brain abnormalities in children and young adults with severe chronic kidney disease.
Background: The pathophysiology of neurological dysfunction in severe chronic kidney disease (CKD) in children and young adults is largely unknown. We aimed to investigate brain volumes and white matter integrity in this population and explore brain structure under different treatment modalities. Me...
| Publicado en: | Pediatric Nephrology Vol. 37; no. 5; pp. 1125 - 1137 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Springer Nature
May2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=156445111&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 156445111 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: May2022 vid: 37 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 156445111 156445111 156445111 10.1007/s00467-021-05276-5 156445111 ppf: 1125 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Structural brain abnormalities in children and young adults with severe chronic kidney disease. aug: au: Lijdsman, Sophie Königs, Marsh van Sandwijk, Marit S. Bouts, Antonia H. van Hoeck, Koen de Jong, Huib Engelen, Marc Oosterlaan, Jaap Bemelman, Frederike J. Oostrom, Kim J. Groothoff, Jaap W. affil: Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction & Development, Emma Children's Hospital, Amsterdam University Medical Centers (Amsterdam UMC), University of Amsterdam, PO Box 22660, G8-136, 1100 DD, Amsterdam, Netherlands sug: subj: Brain Anatomy and Histology Renal Insufficiency, Chronic Physiopathology White Matter Physiology Renal Insufficiency, Chronic Therapy Human Cross Sectional Studies Severity of Illness Glomerular Filtration Rate Child Adolescence Adult Dialysis Kidney Transplantation Neuroradiography Brain Radiography Regression Basal Ganglia Anatomy and Histology Treatment Duration Exploratory Research Child: 6-12 years Adolescent: 13-18 years Adult: 19-44 years ab: Background: The pathophysiology of neurological dysfunction in severe chronic kidney disease (CKD) in children and young adults is largely unknown. We aimed to investigate brain volumes and white matter integrity in this population and explore brain structure under different treatment modalities. Methods: This cross-sectional study includes 24 patients with severe CKD (eGFR < 30) aged 8–30 years (median = 18.5, range = 9.1–30.5) on different therapy modalities (pre-dialysis, n = 7; dialysis, n = 7; transplanted, n = 10) and 21 healthy controls matched for age, sex, and parental educational level. Neuroimaging targeted brain volume using volumetric analysis on T1 scans and white matter integrity with tract-based spatial statistics and voxel-wise regression on diffusion tensor imaging (DTI) data. Results: CKD patients had lower white matter integrity in a widespread cluster of primarily distal white matter tracts compared to healthy controls. Furthermore, CKD patients had smaller volume of the nucleus accumbens relative to healthy controls, while no evidence was found for abnormal volumes of gray and white matter or other subcortical structures. Longer time since successful transplantation was related to lower white matter integrity. Exploratory analyses comparing treatment subgroups suggest lower white matter integrity and smaller volume of the nucleus accumbens in dialysis and transplanted patients relative to healthy controls. Conclusions: Young CKD patients seem at risk for widespread disruption of white matter integrity and to some extent smaller subcortical volume (i.e., nucleus accumbens). Especially patients on dialysis therapy and patients who received a kidney transplant may be at risk for disruption of white matter integrity and smaller volume of the nucleus accumbens. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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