FP109PROSTATE Cancer is Characterized by a Dysregulation of the Immune Response (original) (raw)

2018, Nephrology Dialysis Transplantation

To analyze the differences in central nervous system structure between patients on haemodialysis and non-dialysis dependent CKD patients (NDD-CKD). METHODS: Cross section of KIDBRAIN study that includes 100 patients: 68 on haemodialysis and 32 NDD-CKD (stage 4 and 5). We analyzed grey matter volume (cortical and subcortical), white matter volume and axonal functional integrity evaluated by anisotropy fraction (FA) obtained by brain MRI; also, the influence of the 24 hoursurine creatinine clearance over the structures of the CNS including models adjusted to age, sex, DM, cardiovascular history disease, serum cystatine C and systolic blood pressure. The CNS structural differences between NDD-CKD patients and those on haemodialysis were studied in two models: 1.-including all the patients on haemodialysis (68) and 2.-excluding those with residual renal function (18). RESULTS: Mean age: 60,4615,7 years, male 68%, DM 37,5%, cardiovascular history disease 18,7%, serum cystatine C 3,561,0 mg/dl, systolic blood pressure 139,8619,6 mmHg. We found an independent correlation (Beta: 0,486, p:0,021) in the adjusted model between 24-hours-creatinine clearance (19,66 6 ml/min) and white matter volume (r:0,499, p:0,004). There is no assocciation between 24-hours-creatinine clearance and grey matter volume, anisotropy fraction in NDD-CKD.Globally, there is no differences in grey and white matter volumes and anisotropy fraction in haemodialysis and NDD-CKD patients. However, when we excluded the patients with residual renal function [700ml (300-1050ml)] there is differences in grey matter volume (p:0,038) and white matter volume (p:0,024) but no differences in anisotropy fraction (p:0,16). Multivariable analysis confirmed that haemodialysis patients have a less grey matter volume (p:0,015) independently. On the opposite, white matter volumen is dependent to age, sex and DM. CONCLUSIONS: The loss of renal function is accompanied with structural changes in central nervous system at the expense of less grey and white matter volume. This effect is independent of other cardiovascular risk factors. These changes get worse with the dialysis, especially when the residual renal function is lost.