Children with Kidney Disease Show Changes in Brain Blood Flow
Changes in blood flow in the brains of young patients with chronic kidney disease may explain why many face a higher risk of cognitive impairment.
Research has linked chronic kidney disease with lesions in the brain and deficits in cognitive performance in children.
In a recent study in the journal Radiology, researchers examined young patients with early kidney disease in an effort to tease out the effects of the disease from those of secondary complications, such as hypertension. They measured blood flow in the brain of over 70 patients with kidney disease using arterial spin labeling, an MRI technique that can noninvasively quantify blood flow in the brain, accompanied by neurocognitive tests.
Surprisingly, patients with kidney disease showed higher cerebral blood flow compared with controls in certain brain regions. This could indicate compensatory hyperactivity or a disturbance in the regulation of blood flow in these patients. They also found correlations between white matter cerebral blood flow and blood pressure, suggesting that patients with kidney disease may have problems with cerebrovascular regulation, the process that controls blood pressure in the brain.
The patients and controls showed differences in blood flow in regions of the brain related to cognitive problems. Compared with the controls, patients that showed signs of dysfunctional cerebral blood flow also showed cognitive symptoms like difficulty planning, organizing and paying attention.
The researchers conclude that chronic kidney disease can affect brain physiology and function early on, resulting in blood flow differences and cognitive impairments. The study also demonstrates the value of cerebral blood flow measurements with arterial spin labeling in these patients, a technique that allows one to measure important physiological parameters noninvasively.