Brain Hemodynamics in Patients With End-stage Renal Disease Between Hemodialysis Sessions

Abstract

Introduction. End-stage renal disease has been associated with premature atherosclerosis of the cerebral circulation. The risk of stroke, a frequent complication of uremia as a result of cerebral blood flow reduction, is high in dialysis patients. This study aimed to assess brain hemodynamics between hemodialysis interval periods by transcranial Doppler ultrasonography.

Materials and Methods. In a case-control study, to evaluate cerebral circulation homodynamics, 20 hemodialysis patients and 20 age- gender-matched healthy control subjects underwent transcranial Doppler ultrasonography. Blood parameters were also measured simultaneously. Among hemodialysis patients, these studies were performed 48 hours after a dialysis session.

Results. The mean blood flow velocity (MV) values were significantly higher in the middle cerebral artery (P = .007), anterior cerebral artery (P = .003), posterior cerebral artery-segment 2 (P = .03), basilar artery (P = .05) in hemodialysis patients compared to the controls. The MV had a negative meaningful correlation with hemoglobin and hematocrit in most intracranial arteries of the patients, but no significant correlation was observed between these variables and MV of the arteries in the control group.

Conclusions. The MV of the cerebral arteries significantly increases in hemodialysis patients, which could be due to the decrease in hemoglobin levels in these patients.