Analysis of prefrontal cerebral blood volume and flow changes in ESKD patients undergoing hemodialysis using functional near-infrared spectroscopy

• Published in: Renal failure Vol. 46; no. 2; p. 2387426
• Main Authors: Heo, Chang Min, Yi, Jiyae, Park, Kang Min, Lee, Dong Ah, Lee, Yoo Jin, Park, Bong Soo, Kim, Yang Wook, Ko, Junghae, Kim, Hyunwoo, Park, Sihyung
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis Group 01.12.2024
• Subjects: Adult; Aged; brain; cerebral blood flow; Cerebral Blood Volume; Cerebrovascular Circulation - physiology; Female; Hemodialysis; Hemodynamics; Hemoglobins - analysis; Hemoglobins - metabolism; Humans; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - physiopathology; Kidney Failure, Chronic - therapy; Male; Middle Aged; near-infrared spectroscopy; Prefrontal Cortex - blood supply; Prefrontal Cortex - diagnostic imaging; Prefrontal Cortex - physiopathology; Prospective Studies; Renal Dialysis; Spectroscopy, Near-Infrared; cerebral blood flow; near-infrared spectroscopy; brain; Hemodialysis; cerebral blood volume
• ISSN: 0886-022X; 1525-6049; 1525-6049
• DOI: 10.1080/0886022X.2024.2387426

End-stage kidney disease (ESKD) patients undergoing hemodialysis experience diverse neurological complications. This study investigated prefrontal cerebral blood volume (CBV) and cerebral blood flow (CBF) during hemodialysis using functional near-infrared spectroscopy (fNIRS) to analyze cerebral hemodynamic changes. ESKD patients undergoing maintenance hemodialysis without a history of neurological disorders were enrolled prospectively. The fNIRS data were collected using a NIRSIT Lite device. The fNIRS values were recorded three times for each patient: before the start of hemodialysis (pre-HD), 1 h after the start of hemodialysis (mid-HD), and after the end of hemodialysis (post-HD). The average changes in oxy-hemoglobin (HbO ), deoxy-hemoglobin (HbR), total hemoglobin (HbT, calculated as HbO  + HbR) concentrations, and in hemoglobin concentration difference (HbD, calculated as HbO  - HbR) were analyzed. We then compared the differences in changes in HbO , HbR, HbT, and HbD according to the hemodialysis period. Thirty hemodialysis patients were analyzed. The change in HbO , HbT, and HbD levels showed significant differences according to the hemodialysis period. Between the pre-HD and post-HD periods, there were significant differences in changes in HbO (0.005 ± 0.001 µM vs. 0.015 ± 0.004 µM,  = .046) and HbT (0.006 ± 0.001 µM vs. 0.016 ± 0.008 µM,  = .029). Additionally, between pre-HD and post-HD periods, HbD tended to increase (0.005 ± 0.001 µM vs. 0.014 ± 0.004 µM,  = .094). We demonstrated that during one hemodialysis session, the relative change in prefrontal CBV increased post-HD compared with pre-HD. These results are expected to help understanding the mechanisms underlying the effects of hemodialysis on brain function.