New research suggests dialysis may cause progressive brain injury
Treatment for kidney failure may soon involve brain injury management, as a new study shows that dialysis is linked to short-term ‘cerebral stunting’ and long-term progressive brain injury when undergoing years of treatment.
For those not eligible or years away from a kidney transplant, the findings provide a clear need for better neurologic monitoring and management while receiving the life-saving condition.
The study, published in the Journal of the American Society of Nephrology, examined nearly 100 patients receiving dialysis, including measuring cerebral blood flow and cognitive function. Specifically, the researchers tracked 97 patients with end-stage renal disease who were receiving hemodialysis over a 12-month period, using tests of cognitive function and MRI scanning to measure any white matter injury.
Based on the findings, the researchers say dialysis contributes to reduced blood flow in the brain which appears to be directly related to decreased cognitive function.
Over longer periods of time, the team also found an increased risk for progressive brain injury brought on by the reduced blood flow during the procedure.
However, the research also suggests that receiving a kidney transplant and discontinuing dialysis can effectively reverse the cognitive impairment, improve memory, and increase verbal learning brain functions.
Medical professionals have long recognized that dialysis was tied to observable cognitive impairment, with up to 70% of those receiving the procedure showing signs of impairment. However, the cause behind this relationship has remained unclear until now.
Professor Patrick Mark, Professor of Nephrology at the University of Glasgow, said: “This is an important study which we believe supports the current hypothesis that dialysis is associated with progressive brain injury. Crucially we found that while patients both on short and long-term dialysis treatment has some form of cognitive impairment, patients who went on to receive a transplant saw an improvement in their white matter and in their memory.”
The findings could also provide a target for better management of cognitive impairment related to dialysis by improving blood flow in the brain. Additionally, it could increase the motivation for providing transplants to those in need.
Fellow researcher, Dr. Mark Findlay – from the University’s Institute of Cardiovascular and Medical Sciences – said, “”Based on our findings it would appear that early recognition of those patients most at risk may help to limit their brain injury, which appears potentially reversible by kidney transplant.”