{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T03:30:36Z","timestamp":1783654236115,"version":"3.55.0"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,12,6]],"date-time":"2020-12-06T00:00:00Z","timestamp":1607212800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,2]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n The haemodynamic stress brought about by dialysis could justify the loss of structural and functional integrity of the central nervous system (CNS). The main objective of this study was to analyse the relationship between intradialytic hypotension (IDH) and cognitive function and brain morphometry.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The cross-sectional KIDBRAIN study (Cohort Study of Morphological Changes of the Brain by MRI in Chronic Kidney Disease Patients) included 68 prevalent patients with no history of neurological disorders (cerebrovascular disease and cognitive impairment) undergoing haemodialysis (HD). We analysed 18 non-consecutive dialysis sessions (first three of each month over a 6-month period) and various definitions of IDH were recorded. Global cognitive function (GCF) was assessed using the Mini-Mental State Examination (MMSE) and parameters of structural integrity of the CNS were obtained using volume morphometry magnetic resonance imaging analysis [grey matter (GM), white matter (WM) and hippocampus).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A greater number of sessions with IDH were associated with less volume of WM (r = \u22120.359,P = 0.003) and hippocampus (r = \u22120.395, P = 0.001) independent of cardiovascular risk factors according to multivariable linear regression models (\u03b2 = \u22120.198, P = 0.046 for WM; \u03b2 = \u22120.253, P = 0.017 for hippocampus). The GCF by the MMSE was 27.3 \u00b1 7.3.1 and was associated with WM volume (\u03b2 = 0.403, P = 0.001) independent of GM and hippocampus volume. Symptomatic IDH was associated with GCF (r = \u22120.420, P\u2009&lt;\u20090.001) in adjusted analysis (\u03b2 = \u22120.339, P = 0.008).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Even when asymptomatic, IDH is associated with a lower WM and hippocampus volume and reduced GCF in patients undergoing HD, thus suggesting greater vulnerability of the brain to the haemodynamic stress that may be generated by a dialysis session.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ckj\/sfaa070","type":"journal-article","created":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T19:21:28Z","timestamp":1585682488000},"page":"1156-1164","source":"Crossref","is-referenced-by-count":16,"title":["Intradialytic hypotension and relationship with cognitive function and brain morphometry"],"prefix":"10.1093","volume":"14","author":[{"given":"Santiago","family":"Cede\u00f1o","sequence":"first","affiliation":[{"name":"Department of Nephrology, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Desco","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasser","family":"Aleman","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00e1s","family":"Mac\u00edas","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Fern\u00e1ndez-Pena","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almudena","family":"Vega","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soraya","family":"Abad","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Manuel","family":"L\u00f3pez-G\u00f3mez","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,12,5]]},"reference":[{"key":"2021060310392998200_sfaa070-B1","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1038\/nrneph.2015.131","article-title":"Kidney-brain crosstalk in the acute and chronic setting","volume":"11","author":"Lu","year":"2015","journal-title":"Nat Rev Nephrol"},{"key":"2021060310392998200_sfaa070-B2","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1038\/ki.2010.336","article-title":"Dementia and cognitive impairment in ESRD: diagnostic and therapeutic strategies","volume":"79","author":"Kurella Tamura","year":"2011","journal-title":"Kidney Int"},{"key":"2021060310392998200_sfaa070-B3","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1097\/TP.0000000000000968","article-title":"Cognitive changes in chronic kidney disease and after transplantation","volume":"100","author":"Van Sandwijk","year":"2016","journal-title":"Transplantation"},{"key":"2021060310392998200_sfaa070-B4","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1111\/sdi.12627","article-title":"A brief review of intradialytic hypotension with a focus on survival","volume":"30","author":"Chou","year":"2017","journal-title":"Semin Dial"},{"key":"2021060310392998200_sfaa070-B5","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.2215\/CJN.12141017","article-title":"McCausland FR. 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