Cognition may be related to arterial pulsatility index in HD patients.
OBJECTIVE
Hemodialysis (HD) patients have a heavy burden of subclinical cerebrovascular disease and cognitive changes consistent with a vascular etiology. Pulsatility index is associated with microangiopathy of cerebral blood vessels and an increased risk of cerebral infarction. The proposed study was to determine common carotid artery pulsatility index (CCAPI) and its relation to cognition in well-dialyzed HD patients with no history of stroke or dementia and matched controls.


METHODS
Observational, cross-sectional study of CCAPI and cognition in 37 hemodialysis outpatients and 18 matched controls with normal kidney function. Non-parametric analyses were used to compare variables between groups. Multiple regression and ANOVA models were used to adjust for risk factor differences.


RESULTS
Controls had a lower CCAPI than the HD group (1.7 ± 0.3 vs. 2.1 ± 0.4 cm/s, p = 0.006). HD patients scored significantly lower on all cognitive domains. Attention correlated with CCAPI in HD patients, independent of hypertension, diabetes, hyperlipidemia, and years on HD (r2 = -0.36, p = 0.01). CCAPI correlated with years on HD, independent of traditional cardiovascular risk factors. (r2 = 0.26, p = 0.04).


CONCLUSIONS
In well-dialyzed hemodialysis patients with no history of stroke or dementia, CCAPI may correlate with cognitive function and represent a marker for underlying cerebral microvascular disease.
Nephrology Division, VA RR&D Center of Excellence for Medical Consequences of SCI, James J. Peters Veterans Affairs Medical Center, Bronx, NY, Department of Physical Therapy, School of Health Professionals, New York Institute of Technology, Old Westbury, NY, VA RR&D, James J. Peters Veterans Affairs Medical Center, Bronx, NY, Departments of Medicine, Psychiatry, and Rehabilitation Medicine, Mount Sinai School of Medicine, NY, USA.
James B
JB
Post
Kel G
KG
Morin
John P
JP
Handrakis
Dwindally Rosado
DR
Rivera
Christina
C
Yen
Mary
M
Sano
Ann M
AM
Spungen
D000368:Aged; D017536:Carotid Artery, Common / Q000503:physiopathology*; D003071:Cognition; D006801:Humans; D008875:Middle Aged; D011673:Pulsatile Flow / Q000502:physiology*; D006435:Renal Dialysis