Cerebral cortical thickness changes in patients with end-stage renal disease without cognitive dysfunction

Objective To investigate the changes of cerebral cortical thickness in patients with end-stage renal disease (ESRD) and the relationship between cortical thickness and kidney function. Methods A total of 35 ESRD patients were enrolled in this study. Systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum creatinine (Cr), blood urea nitrogen (BUN), total cholesterol (TC), serum potassium and serum calcium of those patients were examined. Head MRI was performed to observe the changes of cerebral cortical thickness. Pearson correlation analysis was used to explore the relationship between cerebral cortical thickness and kidney function. Results Compared with normal controls, ESRD patients showed decreased cerebral cortical thickness in right prefrontal cortex, including lateral prefrontal cortex (Peak 1 and 2), medial prefrontal cortex (Peak 3) and ventral prefrontal cortex (Peak 4; P < 0.05, for all, RFT correction). Pearson correlation analysis showed that lateral prefrontal cortex thickness (Peak 1: r = -0.344, P = 0.043; Peak 2: r = -0.335, P = 0.049) and medial prefrontal cortex thickness (Peak 3: r = -0.387, P = 0.021) were negatively correlated with serum Cr; lateral prefrontal cortex thickness (Peak 1: r = -0.384, P = 0.023; Peak 2: r = -0.380, P = 0.024), medial prefrontal cortex thickness (Peak 3: r = -0.470, P = 0.004) and ventral prefrontal cortex thickness (Peak 4: r = -0.440, P = 0.009) were negatively correlated with serum BUN; medial prefrontal cortex thickness (Peak 3) was positively correlated with Hb (r = 0.339, P = 0.046) and was negatively correlated with serum potassium (r = -0.335, P = 0.049); lateral prefrontal cortex thickness (Peak 2) was positively correlated with corrected serum calcium (r = 0.354, P = 0.037). Conclusions ESRD patients had decreased thickness of right prefrontal cortex, including lateral prefrontal cortex, medial prefrontal cortex and ventral prefrontal cortex, which was correlated with kidney function. These results provided compelling evidence for cortical abnormality of ESRD patients, and suggested that kidney function may be the key factor for predicting changes of brain tissue structure. DOI: 10.3969/j.issn.1672-6731.2018.04.00