The influence of hemodialysis on intracranial pressure waveform in patients with chronic kidney disease: an observational study.

IF 1.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Sao Paulo Medical Journal Pub Date : 2023-11-27 eCollection Date: 2023-01-01 DOI:10.1590/1516-3180.2023.0068.R1.07072023
Mariana Schechtel Koch, Bianca Drewnowski, Cristiane Rickli, Fábio André Dos Santos, Gilberto Baroni, José Carlos Rebuglio Vellosa
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Abstract

Background: Among the complications related to chronic kidney disease (CKD), those of a neurological nature stand out, and for a better quality of life for patients, the diagnosis and treatment of these complications is fundamental.

Objectives: This study aimed to assess the effect of hemodialysis on intracranial pressure waveform (ICPw) in patients with chronic kidney disease undergoing hemodialysis and those who are not yet undergoing substitutive therapy.

Design and setting: An observational study was conducted in two stages at a kidney replacement therapy center in Brazil. The first was a longitudinal study and the second was a cross-sectional study.

Methods: Forty-two patients on hemodialysis were included in the first stage of the study. In the second stage, 226 participants were included. Of these, 186 were individuals with chronic kidney disease (who were not undergoing substitutive therapy), and 40 did not have the disease (control group). The participants' intracranial compliance was assessed using the non-invasive Brain4care method, and the results were compared between the groups.

Results: There was a significant difference between the hemodialysis and non-hemodialysis groups, with the former having better ICPw conditions.

Conclusions: Hemodialysis influenced the improvement in ICPw, probably due to the decrease in the patients' extra-and intracellular volumes. Furthermore, ICPw monitoring can be a new parameter to consider when defining the moment to start substitutive therapy.

血液透析对慢性肾病患者颅内压波形的影响:一项观察性研究
背景:在慢性肾脏疾病(CKD)相关的并发症中,神经系统并发症尤为突出,为了提高患者的生活质量,对这些并发症的诊断和治疗至关重要。目的:本研究旨在评估血液透析对接受血液透析和尚未接受替代治疗的慢性肾病患者颅内压波形(ICPw)的影响。设计和背景:一项观察性研究在巴西的肾脏替代治疗中心分两个阶段进行。第一个是纵向研究第二个是横断面研究。方法:将42例血液透析患者纳入第一阶段研究。在第二阶段,226名参与者被纳入。其中,186人患有慢性肾病(未接受替代治疗),40人没有肾病(对照组)。使用无创的Brain4care方法评估参与者的颅内依从性,并比较两组之间的结果。结果:血液透析组与非血液透析组之间存在显著性差异,血液透析组ICPw状况较好。结论:血液透析影响了ICPw的改善,可能是由于患者细胞外和细胞内体积的减少。此外,在确定开始替代治疗的时机时,ICPw监测可以作为考虑的新参数。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Sao Paulo Medical Journal
Sao Paulo Medical Journal 医学-医学:内科
CiteScore
2.20
自引率
7.10%
发文量
210
审稿时长
6-12 weeks
期刊介绍: Published bimonthly by the Associação Paulista de Medicina, the journal accepts articles in the fields of clinical health science (internal medicine, gynecology and obstetrics, mental health, surgery, pediatrics and public health). Articles will be accepted in the form of original articles (clinical trials, cohort, case-control, prevalence, incidence, accuracy and cost-effectiveness studies and systematic reviews with or without meta-analysis), narrative reviews of the literature, case reports, short communications and letters to the editor. Papers with a commercial objective will not be accepted.
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