Regional cerebral blood flow in children and young adults with chronic kidney disease

H.-S. Liu, E.A. Hartung, A.F. Jawad, J.B. Ware, N. Laney, A.M. Port, R.C. Gur, S.R. Hooper, J. Radcliffe, S.L. Furth, J.A. Detre

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Abstract

Purpose: To investigate the pathophysiologic effects of chronic kidney disease (CKD) on brain function in children with CKD by correlating cerebral blood flow (CBF) with clinical and behavioral indexes. Materials and Methods: In this prospective study, 73 pediatric patients with CKD (mean age, 15.80 years 6 3.63; range, 9-25 years) and 57 control subjects (mean age, 15.65 years 6 3.76; range, 9-25 years) were recruited. CBF measurements were acquired with an MRI arterial spin labeling scheme. Neurocognitive measurements were performed with traditional and computerized neurocognitive batteries. Clinical data were also collected. Group-level global and regional CBF differences between patients with CKD and control subjects were assessed. Regression analyses were conducted to evaluate the associations among regional CBF, clinical variables, and cognitive performance. Results: Patients with CKD showed higher global CBF compared with control subjects that was attributable to reduced hematocrit level (mean, 60.2 mL/100 g/min 6 9.0 vs 56.5 mL/100 g/min 6 8.0, respectively). White matter CBF showed correlation with blood pressure (r = 0.244, P = .039), a finding suggestive of altered cerebrovascular autoregulation. Regional CBF differences between patients and control subjects included regions in the “default mode” network. In patients with CKD, positive extrema in the precuneus showed a strong correlation with executive function (r = 0.608, P = .001). Conclusion: Systemic effects of estimated glomerular filtration rate, hematocrit level, and blood pressure on CBF and alterations in regional CBF may reflect impaired brain function underlying neurocognitive symptoms in CKD. These findings further characterize the nature of alterations in brain physiologic features in children, adolescents, and young adults with CKD. © RSNA, 2018
Original languageEnglish
Pages (from-to)849-858
Number of pages10
JournalRadiology
Volume288
Issue number3
DOIs
Publication statusPublished - Sep 2018

Keywords

  • adolescent
  • adult
  • arterial spin labeling
  • Article
  • autoregulation
  • blood pressure
  • brain blood flow
  • brain region
  • child
  • chronic kidney failure
  • cognition
  • controlled study
  • cross-sectional study
  • default mode network
  • estimated glomerular filtration rate
  • executive function
  • female
  • hematocrit
  • human
  • major clinical study
  • male
  • neuroimaging
  • precuneus
  • priority journal
  • prospective study
  • white matter
  • brain
  • brain circulation
  • diagnostic imaging
  • nuclear magnetic resonance imaging
  • pathophysiology
  • physiology
  • procedures
  • young adult
  • spin label
  • Adolescent
  • Adult
  • Brain
  • Cerebrovascular Circulation
  • Child
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Prospective Studies
  • Renal Insufficiency, Chronic
  • Spin Labels
  • Young Adult

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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  • Cite this

    Liu, H-S., Hartung, E. A., Jawad, A. F., Ware, J. B., Laney, N., Port, A. M., Gur, R. C., Hooper, S. R., Radcliffe, J., Furth, S. L., & Detre, J. A. (2018). Regional cerebral blood flow in children and young adults with chronic kidney disease. Radiology, 288(3), 849-858. https://doi.org/10.1148/radiol.2018171339