title: Increased Number and Distribution of Cerebral Microbleeds Is a Risk Factor for Cognitive Dysfunction in Hemodialysis Patients: A Longitudinal Study.
abstract: The aim of this study was to explore the risk factors associated with longitudinal changes in hemodialysis patients including the correlation between number and distribution of cerebral microbleeds (CMBs).Sixty-one hemodialysis patients were enrolled in this prospective study. Twenty-eight patients had follow-up examinations with a mean interval of 24.79 ± 5.17 months. The number of CMBs was manually counted on susceptibility-weighted imaging. Subjects were divided into 2 groups with and without CMBs. In the CMB group, 8 of 33 patients did not have a mini-mental state examination (MMSE) because of blurred vision. Multiple logistic regression was used to investigate the risk factors for CMBs. Partial correlation was used to explore the correlation between the increased number of CMBs and the change of MMSE scores.CMBs were seen in 33 (54%) hemodialysis patients. Both age and pre/postdialysis systolic blood pressure (SBP) positively correlated with CMBs. Serum iron (SI), and high-density lipoprotein cholesterol (HDL-c) negatively correlated with CMBs (all P < 0.05). Among 25 patients with CMBs and MMSE, 9 patients had scores <27, which was considered as subnormal and most CMBs in these patients were located in the brainstem and basal ganglia. Considering age and follow-up time as the co-confounding factors, the number of new CMBs over the 2 imaging time points negatively correlated with the change of MMSE scores (r = -0.673, P = 0.023).The presence of new CMBs was a risk factor for cognitive dysfunction and the location of CMBs may be correlated with cognitive impairment. Both SI and HDL-c were protective factors for the CMBs. The risk factors for CMBs included age, pre- and postdialysis SBP.
authors.affiliation: From the Department of Radiology, Tianjin First Central Hospital, Tianjin (CC, MZ, CZ, LL, WS, SX); Department of Radiology, Yuhuang Ding Hospital, Yantai, ShanDong (ZW); Department of Prophylactic Inoculation, Tianjin First Central Hospital, Tianjin (LF); Department of haemodialysis, Tianjin First Central Hospital, Tianjin (ZC); Department of Radiology, Wayne State University, Detroit, MI (EMH); and Department of Radiology, CNPC Central Hospital (WG), Langfang, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Chai
authors.forename: Zhiye
authors.initials: Z
authors.lastname: Wang
authors.forename: Linlin
authors.initials: L
authors.lastname: Fan
authors.forename: Mengjie
authors.initials: M
authors.lastname: Zhang
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Chu
authors.forename: Chao
authors.initials: C
authors.lastname: Zuo
authors.forename: Lei
authors.initials: L
authors.lastname: Liu
authors.forename: E
authors.initials: E
authors.lastname: Mark Haacke
authors.forename: Wenmei
authors.initials: W
authors.lastname: Guo
authors.forename: Wen
authors.initials: W
authors.lastname: Shen
authors.forename: Shuang
authors.initials: S
authors.lastname: Xia
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001794:Blood Pressure; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000453:epidemiology*; D059345:Cerebral Small Vessel Diseases / Q000150:complications* / Q000453:epidemiology*; D002681:China; D003072:Cognition Disorders / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D013223:Statistics as Topic; D055815:Young Adult