Glymphatic system dysfunction in nondialysis-dependent ESRD patients with diabetic kidney disease: associations with clinical characteristics and cognitive function.

IF 3 3区医学 Q1 UROLOGY & NEPHROLOGY

Renal Failure Pub Date : 2024-12-01 Epub Date: 2024-11-07 DOI:10.1080/0886022X.2024.2425160

Bingxin Yu, Wenbo Yang, Lijun Song, Mingan Li, Boyan Xu, Zhenchang Wang, Zongli Diao, Hao Wang

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引用次数: 0

Abstract

Objectives: To investigate glymphatic function in nondialysis-dependent ESRD (ND-ESRD) patients with diabetic kidney disease (DKD) or non-DKD using the diffusion tensor image analysis along the perivascular space (DTI-ALPS) method and choroid plexus (CP) volume to explore the associations among DTI-ALPS index, CP volume, clinical characteristics, and cognitive function.

Methods: 25 DKD patients, 25 non-DKD patients, and 25 healthy control (HC) were included in this study. All participants underwent cerebral MRI and cognitive assessments. Bilateral DTI-ALPS index and CP volume were calculated and were compared among three groups. Correlations among the DTI-ALPS index, CP volume, clinical characteristics, and cognitive function were analyzed.

Results: DKD patients had significantly lower left DTI-ALPS index (p = 0.001) and mean DTI-ALPS index (p = 0.003) than non-DKD patients. In ND-ESRD patients, there was a significant positive correlation between the left DTI-ALPS index and phosphorus (r = 0.377, p = 0.007) and attention score (r = 0.434, p = 0.002). In DKD group, the mean DTI-ALPS was positively correlated with total cholesterol (r = 0.631, p = 0.001). In non-DKD group, there was a significant positive correlation between the left DTI-ALPS index and phosphorus (r = 0.696, p < 0.001). Both DKD and non-DKD patients exhibited significant higher CP volume than HC group. In non-DKD group, CP volume was negatively correlated with mean DTI-ALPS (r = -0.535, p = 0.006) and attention score of MoCA (r = -0.538, p = 0.006).

Conclusions: Glymphatic system dysfunction may contribute to the pathogenesis of clinical and cognitive impairment in ND-ESRD patients especially with DKD.

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非透析依赖型 ESRD 糖尿病肾病患者的胃动力系统功能障碍：与临床特征和认知功能的关系。

目的使用沿血管周围空间的弥散张量图像分析（DTI-ALPS）方法和脉络丛（CP）体积研究非透析依赖性 ESRD（ND-ESRD）糖尿病肾病（DKD）或非 DKD 患者的脑功能，探讨 DTI-ALPS 指数、CP 体积、临床特征和认知功能之间的关联。所有参与者均接受了脑磁共振成像和认知评估。计算双侧 DTI-ALPS 指数和 CP 容量，并在三组之间进行比较。分析了DTI-ALPS指数、CP体积、临床特征和认知功能之间的相关性：结果：DKD 患者的左侧 DTI-ALPS 指数（p = 0.001）和平均 DTI-ALPS 指数（p = 0.003）明显低于非 DKD 患者。在 ND-ESRD 患者中，左侧 DTI-ALPS 指数与磷（r = 0.377，p = 0.007）和注意力评分（r = 0.434，p = 0.002）呈显著正相关。在 DKD 组，DTI-ALPS 平均值与总胆固醇呈正相关（r = 0.631，p = 0.001）。在非 DKD 组中，左侧 DTI-ALPS 指数与磷（r = 0.696，p = 0.006）和 MoCA 注意力评分（r = -0.538，p = 0.006）呈显著正相关：淋巴系统功能障碍可能是导致 ND-ESRD 患者（尤其是 DKD 患者）临床和认知功能障碍的发病机制之一。

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

Renal Failure 医学-泌尿学与肾脏学

CiteScore

3.90

自引率

13.30%

发文量

374

审稿时长

1 months

期刊介绍： Renal Failure primarily concentrates on acute renal injury and its consequence, but also addresses advances in the fields of chronic renal failure, hypertension, and renal transplantation. Bringing together both clinical and experimental aspects of renal failure, this publication presents timely, practical information on pathology and pathophysiology of acute renal failure; nephrotoxicity of drugs and other substances; prevention, treatment, and therapy of renal failure; renal failure in association with transplantation, hypertension, and diabetes mellitus.