{"title":"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。","authors":"Bingxin Yu, Wenbo Yang, Lijun Song, Mingan Li, Boyan Xu, Zhenchang Wang, Zongli Diao, Hao Wang","doi":"10.1080/0886022X.2024.2425160","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>DKD patients had significantly lower left DTI-ALPS index (<i>p</i> = 0.001) and mean DTI-ALPS index (<i>p</i> = 0.003) than non-DKD patients. In ND-ESRD patients, there was a significant positive correlation between the left DTI-ALPS index and phosphorus (<i>r</i> = 0.377, <i>p</i> = 0.007) and attention score (<i>r</i> = 0.434, <i>p</i> = 0.002). In DKD group, the mean DTI-ALPS was positively correlated with total cholesterol (<i>r</i> = 0.631, <i>p</i> = 0.001). In non-DKD group, there was a significant positive correlation between the left DTI-ALPS index and phosphorus (<i>r</i> = 0.696, <i>p</i> < 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, <i>p</i> = 0.006) and attention score of MoCA (r = -0.538, <i>p</i> = 0.006).</p><p><strong>Conclusions: </strong>Glymphatic system dysfunction may contribute to the pathogenesis of clinical and cognitive impairment in ND-ESRD patients especially with DKD.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"46 2","pages":"2425160"},"PeriodicalIF":3.0000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544731/pdf/","citationCount":"0","resultStr":"{\"title\":\"Glymphatic system dysfunction in nondialysis-dependent ESRD patients with diabetic kidney disease: associations with clinical characteristics and cognitive function.\",\"authors\":\"Bingxin Yu, Wenbo Yang, Lijun Song, Mingan Li, Boyan Xu, Zhenchang Wang, Zongli Diao, Hao Wang\",\"doi\":\"10.1080/0886022X.2024.2425160\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>DKD patients had significantly lower left DTI-ALPS index (<i>p</i> = 0.001) and mean DTI-ALPS index (<i>p</i> = 0.003) than non-DKD patients. In ND-ESRD patients, there was a significant positive correlation between the left DTI-ALPS index and phosphorus (<i>r</i> = 0.377, <i>p</i> = 0.007) and attention score (<i>r</i> = 0.434, <i>p</i> = 0.002). In DKD group, the mean DTI-ALPS was positively correlated with total cholesterol (<i>r</i> = 0.631, <i>p</i> = 0.001). In non-DKD group, there was a significant positive correlation between the left DTI-ALPS index and phosphorus (<i>r</i> = 0.696, <i>p</i> < 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, <i>p</i> = 0.006) and attention score of MoCA (r = -0.538, <i>p</i> = 0.006).</p><p><strong>Conclusions: </strong>Glymphatic system dysfunction may contribute to the pathogenesis of clinical and cognitive impairment in ND-ESRD patients especially with DKD.</p>\",\"PeriodicalId\":20839,\"journal\":{\"name\":\"Renal Failure\",\"volume\":\"46 2\",\"pages\":\"2425160\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544731/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Renal Failure\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/0886022X.2024.2425160\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/11/7 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Renal Failure","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/0886022X.2024.2425160","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/7 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Glymphatic system dysfunction in nondialysis-dependent ESRD patients with diabetic kidney disease: associations with clinical characteristics and cognitive function.
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.
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.
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