According to Neuroscience News, a new study has shown that children with chronic kidney disease, CKD, also display changes in cerebral blood flow that could cause higher risk of cognitive impairment.
Chronic kidney disease, abbreviated CKD, is exactly what it sounds like: continual damage to the kidneys that gets worse and worse over time. Since the kidneys play an important role in filtering out excess fluids in the human body, chronic kidney disease causes a dangerous buildup of dangerous levels of fluid, electrolytes, and waste. Some symptoms of CKD include jaundice, nausea, sleep issues, fatigue and weakness, persistent itching, and more. Treatment for CKD typically involves controlling symptoms and reducing complications as well as slowing the progression of the debilitating disease. To read more about CKD, click here.
In line with this research, prior studies have found that CKD is related to injuries in the brain’s white matter as well as cognitive performance deficits. CKD in grown-ups is often related to disorders like diabetes and hypertension. The study was aimed towards children, as CKD in kids still has implications for cognitive development.
“It’s not clear if the brain problems from kidney disease seen in adults are secondary to the hypertension produced by the disease,” explained coauthor of the study John A. Detre, M.D., professor at the University of Pennsylvania (medical school).
“In our study, we wanted to look at patients with early kidney disease, before they’ve experienced decades of high blood pressure,” Detre explain. “In doing this, we could separate the kidney disease effects from those of chronic high blood pressure.”
Detre and his team looked at the cerebral blood flow of 73 pediatric CKD patients compared to 57 participants in a comparably aged control group. Using an MRI technique, they found that patients with CKD had higher levels of blood flow in the brain compared to the control group in specific regions of the brain.
This was alarming, as lower levels of cognitive performance are normally associated with decreased cerebral blood flow. Detre had some ideas for this phenomenon.
“It may indicate compensatory hyperactivity, in which the brain regions are working extra hard to maintain performance,” Dr. Detre said. “Another possibility is that there’s a disturbance in the regulation of blood flow in these patients.”
The team also found that white matter cerebral blood flow was related to blood pressure, which implies that CKD patients may have problems with cerebrovascular autoregulation, a process responsible for controlling cerebral blood pressure. Dr. Detre believes this malfunction could result in white matter damage.
“Chronic kidney disease appears to affect brain physiology and function even early in the disease,” said Detre. “This study gives us clues about what changes in brain physiology might underlie cognitive changes.”
These changes included the different areas of differences in cerebral blood flow. CKD patients had blood flow differences in an area of the brain that is active when someone is not particularly concentrated on a task.
“Cerebral blood flow is a critically important physiological parameter that you can measure in just a few minutes with arterial spin labeling,” said Dr. Detre. “This technique provides a noninvasive way of quantifying cerebral blood flow that doesn’t require use of contrast agent, which is contraindicated in patients with kidney dysfunction.”
To learn more about what the research entailed, click here.
