Kidney Week

Abstract: FR-OR24

Measurement of Cerebral Blood Flow Using Transcranial Doppler Ultrasonography: Comparison of Two Populations of Patients on Chronic Hemodialysis

Session Information

• Dialysis: What's New in Techniques and Management
  October 25, 2024 | Location: Room 8, Convention Center
  Abstract Time: 05:20 PM - 05:30 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Cruz Mendoza, Néstor Humberto, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico

Néstor Humberto Cruz Mendoza, MD

• Del Toro-Cisneros, Noemi, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico

Noemi Del Toro-Cisneros, MD

• Geraldo Murillo, Jose Adrian, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico

Jose Adrian Geraldo Murillo, MD

• Ardavin Ituarte, Juan M., Médica Santa Carmen, Ciudad de Mexico, Mexico City, Mexico

Juan M. Ardavin Ituarte, MD

• Gómez Ruiz, Ismael Antonio, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico

Ismael Antonio Gómez Ruiz, MD

• Correa-Rotter, Ricardo, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico

Ricardo Correa-Rotter, MD

• Vega, Olynka, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico

Olynka Vega, MD, MS

Background

Patients on hemodialysis (HD) experience systemic and cerebral hemodynamic changes that are associated with cognitive impairment. The objective of this study was to quantify and compare hemodynamic changes at the cerebral level during an HD session in patients with AVF vs. those with a high-flow catheter (HFC).

Methods

Cross-sectional study, controls were sought for AVF patients matched for age, sex, and time on HD. Three measurements of mean cerebral blood flow velocity (CBFV) were performed using transcranial Doppler ultrasound (during the first 15 minutes,120 and 240 minutes after HD). Other interventions were carried out before and after HD, including measurement of cardiac output (CO), cognitive evaluation using the Montreal Cognitive Assessment (MoCA), and measurement of AVF flow velocity.

Results

Fifty patients were included, 20 women, average age 56 years, time on HD 3.2 years, 25 patients with AVF (50%). The groups were not different in their baseline characteristics. All patients presented a drop in CBFV, on average -26.5%, with the drop being greater in AVF vs. HFC (-28.2% vs -21.2%, p=0.27). The change in CO pre and post HD was also greater in those with AVF vs. HFC (-12.5% vs -7.6%, p=0.73). Regarding mean arterial pressure (MAP), the change was -11.3% in patients with AVF and -9.4% in HFC (p=0.90). (Fig. 1). There was no difference in MoCA score between the groups.

Conclusion

All patients studied presented a significant decrease in cerebral blood flow, CO and MAP during the HD session. Interestingly, these changes are more pronounced in patients with AVF, but no statistically significant difference was observed between the study groups.