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Neurocognitive impairment in CKD may be due to functional vs structural brain differences
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Investigators found an association between chronic kidney disease in children and young adults and lower gray matter and higher white matter volumes in some regions of interest using MRI. However, differences in the brain structure were not correlated with neurocognitive performance, which researchers say demonstrates neurocognitive impairment in CKD may be due to functional rather than structural differences.
Researchers identified 85 patients with CKD stages 2 to 5 and 63 healthy controls between 8 and 25 years old. Predictors of MRI findings included CKD vs. controls, eGFR and kidney transplant status. Investigators analyzed MRI volumes in 19 prespecified regions of gray matter, white matter and cerebrospinal fluid as predictors of neurocognitive performance in seven prespecified domains. The MRI regions of interest (ROIs) were compared between patients with CKD and healthy controls with unadjusted t tests and ANCOVA. Linear regression and ANCOVA were used to analyze correlations between ROI volume with eGFR and kidney transplant status and correlations between neurocognitive performance and ROI volumes.
Results from the unadjusted analysis showed patients with CKD had less whole-brain cortical and left parietal gray matter volume compared with controls. However, in the adjusted analysis, no differences were seen between patients with CKD and controls. Investigators noted that in patients with CKD, there was an association between less eGFR and higher white matter volume in the whole brain and frontal ROIs; however, there was no significant difference after multiple comparisons correction. Recipients of a kidney transplant had less gray matter volumes in the whole-brain, frontal and left and right parietal ROIs and greater whole-brain white matter volume. There was no correlation between neurocognitive performance in patients with CKD and ROI volumes. – by Monica Jaramillo
Disclosure: The study was funded in part under a Commonwealth Universal Research Enhancement grant with the Pennsylvania Department of Health, # SAP 4100054843.
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