title: Increased cerebral water content in hemodialysis patients.
abstract: Little information is available on the impact of hemodialysis on cerebral water homeostasis and its distribution in chronic kidney disease. We used a neuropsychological test battery, structural magnetic resonance imaging (MRI) and a novel technique for quantitative measurement of localized water content using 3T MRI to investigate ten hemodialysis patients (HD) on a dialysis-free day and after hemodialysis (2.4±2.2 hours), and a matched healthy control group with the same time interval. Neuropsychological testing revealed mainly attentional and executive cognitive dysfunction in HD. Voxel-based-morphometry showed only marginal alterations in the right inferior medial temporal lobe white matter in HD compared to controls. Marked increases in global brain water content were found in the white matter, specifically in parietal areas, in HD patients compared to controls. Although the global water content in the gray matter did not differ between the two groups, regional increases of brain water content in particular in parieto-temporal gray matter areas were observed in HD patients. No relevant brain hydration changes were revealed before and after hemodialysis. Whereas longer duration of dialysis vintage was associated with increased water content in parieto-temporal-occipital regions, lower intradialytic weight changes were negatively correlated with brain water content in these areas in HD patients. Worse cognitive performance on an attention task correlated with increased hydration in frontal white matter. In conclusion, long-term HD is associated with altered brain tissue water homeostasis mainly in parietal white matter regions, whereas the attentional domain in the cognitive dysfunction profile in HD could be linked to increased frontal white matter water content.
authors.affiliation: Department of Neurology, RWTH Aachen University Hospital, Germany; Institute of Neuroscience and Medicine (INM-4), Research Centre Jülich GmbH, Jülich, Germany; Jülich Aachen Research Alliance (JARA)-Translational Brain Medicine, Jülich and Aachen, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Reetz
authors.affiliation: Department of Neurology, RWTH Aachen University Hospital, Germany; Institute of Neuroscience and Medicine (INM-4), Research Centre Jülich GmbH, Jülich, Germany; Jülich Aachen Research Alliance (JARA)-Translational Brain Medicine, Jülich and Aachen, Germany.
authors.forename: Zaheer
authors.initials: Z
authors.lastname: Abbas
authors.affiliation: Department of Neurology, RWTH Aachen University Hospital, Germany; Jülich Aachen Research Alliance (JARA)-Translational Brain Medicine, Jülich and Aachen, Germany.
authors.forename: Ana Sofia
authors.initials: AS
authors.lastname: Costa
authors.affiliation: Institute of Neuroscience and Medicine (INM-4), Research Centre Jülich GmbH, Jülich, Germany.
authors.forename: Vincent
authors.initials: V
authors.lastname: Gras
authors.affiliation: Department of Neurology, RWTH Aachen University Hospital, Germany; Jülich Aachen Research Alliance (JARA)-Translational Brain Medicine, Jülich and Aachen, Germany.
authors.forename: Frances
authors.initials: F
authors.lastname: Tiffin-Richards
authors.affiliation: Department of Neurology, RWTH Aachen University Hospital, Germany; Institute of Neuroscience and Medicine (INM-4), Research Centre Jülich GmbH, Jülich, Germany; Jülich Aachen Research Alliance (JARA)-Translational Brain Medicine, Jülich and Aachen, Germany.
authors.forename: Shahram
authors.initials: S
authors.lastname: Mirzazade
authors.affiliation: KfH Kuratorium für Dialyse und Nierentransplantation e.V., Stolberg, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Holschbach
authors.affiliation: Department of Internal Medicine, St.-Antonius-Hospital Eschweiler, Eschweiler, Germany.
authors.forename: Rolf Dario
authors.initials: RD
authors.lastname: Frank
authors.affiliation: Dialysezentrum Aachen, Praxis und Dialyse, Aachen, Germany.
authors.forename: Athina
authors.initials: A
authors.lastname: Vassiliadou
authors.affiliation: Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany.
authors.forename: Thilo
authors.initials: T
authors.lastname: Krüger
authors.affiliation: Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Eitner
authors.affiliation: Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany.
authors.forename: Theresa
authors.initials: T
authors.lastname: Gross
authors.affiliation: Department of Neurology, RWTH Aachen University Hospital, Germany; Jülich Aachen Research Alliance (JARA)-Translational Brain Medicine, Jülich and Aachen, Germany.
authors.forename: Jörg Bernhard
authors.initials: JB
authors.lastname: Schulz
authors.affiliation: Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Floege
authors.affiliation: Department of Neurology, RWTH Aachen University Hospital, Germany; Institute of Neuroscience and Medicine (INM-4), Research Centre Jülich GmbH, Jülich, Germany; Jülich Aachen Research Alliance (JARA)-Translational Brain Medicine, Jülich and Aachen, Germany.
authors.forename: Nadim Jon
authors.initials: NJ
authors.lastname: Shah
mesh_terms: D001834:Body Water; D001921:Brain / Q000378:metabolism*; D016022:Case-Control Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy; D008279:Magnetic Resonance Imaging; D006435:Renal Dialysis
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