Cerebral blood flow pulsatility and cerebral artery stiffness acutely decrease during hemodialysis. Issue 4 (17th February 2023)

• Record Type: Journal Article
• Authors: Paré, Mathilde; Obeid, Hasan; Labrecque, Lawrence; Drapeau, Audrey; Brassard, Patrice; Agharazii, Mohsen
• Is Part Of: Physiological reports. Volume 11:Issue 4(2023)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2023-02-17
• Subjects: arterial stiffness -- cerebral pulsatility index -- end‐stage kidney disease -- hemodialysis -- middle cerebral artery mean blood velocity -- pulse wave velocity; Physiology -- Periodicals; 571
• DOI: 10.14814/phy2.15595
• Languages: English
• ISSNs: 2051-817X

Abstract

Abstract: End‐stage kidney disease (ESKD) is associated with increased arterial stiffness and cognitive impairment. Cognitive decline is accelerated in ESKD patients on hemodialysis and may result from repeatedly inappropriate cerebral blood flow (CBF). The aim of this study was to examine the acute effect of hemodialysis on pulsatile components of CBF and their relation to acute changes in arterial stiffness. In eight participants (age: 63 ± 18 years, men: 5), CBF was estimated using middle cerebral artery blood velocity (MCAv) assessed with transcranial Doppler ultrasound before, during, and after a single hemodialysis session. Brachial and central blood pressure, along with estimated aortic stiffness (eAoPWV) were measured using an oscillometric device. Arterial stiffness from heart to MCA was measured as the pulse arrival time (PAT) between electrocardiogram (ECG) and transcranial Doppler ultrasound waveforms (cerebral PAT). During hemodialysis, there was a significant reduction in mean MCAv (−3.2 cm/s, p < 0.001), and systolic MCAv (−13.0 cm/s, p < 0.001). While baseline eAoPWV (9.25 ± 0.80 m/s) did not significantly change during hemodialysis, cerebral PAT increased significantly (+0.027, p < 0.001) and was associated with reduced pulsatile components of MCAv. This study shows that hemodialysis acutely reduces stiffness of arteries perfusing the brain along with pulsatile components of blood velocity. Abstract : This study assesses changes in cerebral blood velocity and regional arterial stiffness during hemodialysis. It shows an acute reduction of mean and pulsatile components of cerebral blood velocity, along with a reduction in the stiffness of arteries supplying the middle cerebral artery. This is the first study to assess cerebral artery stiffness in the setting of hemodialysis.