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Abstract Details

Difference of cerebral flows in uremia as a cause of encephalopathy. Follow-up by Transcranial Doppler
Cerebrovascular Disease and Interventional Neurology
P10 - Poster Session 10 (5:30 PM-6:30 PM)
4-005
Document the pathophysiology that causes uremic encephalopathy in patients with  chronic kidney disease with acute exacerbation.
In 1991, Alfredo Postiglione et al. analyzed alterations in cerebral flow with transcranial Doppler in uremic patients before and after hemodialysis, finding that patients experienced decreased blood flow velocity in the arteries of brain after  hemodialysis (HD).

Thirty-three patients diagnosed with chronic kidney disease acute exacerbation (CKD-AE) were included. Blood flow rates were established using transcranial Doppler at hospital admission and after BUN < 50 mg/dL. Mean, standard deviation and T student test were used for related samples.

 

This cohort includes 54.5% males, median age 50 (±12.4 years). CKD of 2.04 years of evolution, patients received 2.95 HD therapy sessions, Pre HD creatinine 15.06 (SD 7.14), post HD 7.18 (SD 2.66), p=0.000; Pre HD BUN 130.6 (SD52.1), post HD BUN 49.31 (SD 13.54), p=0.156; difference between both MCA systolic flow pre HD 25.31 (0-73.58) *, post HD 26.98 (0-60.18) *, p = 0.65; difference between both MCA diastolic flow pre HD 34.37 (8.7 - 78.95) *, post HD 11.11 (0-55.56) *, p = 0.002, MOCA test pre HD 11.04 (SD 6.3), post HD 16.52 (SD 5.93), p = 0.000 * Wilcoxon test is used.

It is currently unknown if there is a relationship between urea levels and variations in cerebral blood flow rates. Endothelial dysfunction has been described as a causal substrate for Chronic Kidney Disease, it is important to identify whether this occurs in general in blood vessels in episodes of acute uremia, including in cerebral blood vessels (anterior / posterior circulation).

Our research documents a significant difference in diastolic flow variations p = 0.002, creatinine levels p=0.000, Moca score p=0.000 post HD therapy. These data  shown that endothelial damage during episodes of uremia is generalized.

Authors/Disclosures
Leticia Alejandra Olguín-Ramírez, Jr. (Instituto De Neurologia Y Neurocirugia, Hospital Zambrano Hellion)
PRESENTER 		No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
Denisse G. Martinez Roque, Jr. (Universidad Autonoma de San Luis Potosí) Miss Martinez Roque has nothing to disclose.
Horacio Chapa-Martinez No disclosure on file
No disclosure on file
No disclosure on file