Cerebral atrophy in patients on long-term regular hemodialysis treatment.
The presence of Cerebral Atrophy in the form of cortical damage (Cortical Atrophy) or subcortical damage (enlargement of ventricular cavities) was explored by computed tomography (CT) scans in 30 patients maintained on regular hemodialysis treatment (RDT) for not less than 10 years, and less than 50 years of age. Whereas a group of 50 normal subjects of the same age, used as control, gave no evidence of cerebral atrophy, 46.6% of the patients maintained on RDT showed cortical atrophy, evenly diffuse in half the cases and predominantly frontal in the other half. In addition 16.6% of the patients showed subcortical atrophy, even in the absence of evident central neurologic or neuropsychic symptoms. In a search for the possible causes of this high incidence of cerebral atrophy in chronic hemodialysis patients we reviewed the last five years' profiles of clinical and blood biochemistry parameters known or suspected to produce brain damage when altered, as stored in a computer system available to our Hemodialysis Unit: these were mean blood pressure before and after hemodialysis, blood cholesterol and triglyceride assays, and mean daily oral intake of A1(OH)3. The status of arterial blood vessels in terms of vascular calcification in soft tissue roentgenograms was also defined; then we correlated these clinical and biochemical indices with the findings of cerebral CT scans by the Fisher test and Discriminant Analysis. The Fisher test revealed a decreasing correlation of cerebral atrophy with mean blood pressure, A1(OH)3 intake, blood cholesterol content, arterial calcifications and blood trygliceride assay in that order.(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D000536:Aluminum Hydroxide / Q000009:adverse effects; D000704:Analysis of Variance; D001284:Atrophy / Q000209:etiology; D001921:Brain / Q000473:pathology*; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000473:pathology; D002552:Cerebral Ventricles / Q000473:pathology; D014695:Cerebral Ventriculography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014511:Uremia / Q000628:therapy
D000536:Aluminum Hydroxide