{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T05:02:13Z","timestamp":1782363733363,"version":"3.54.5"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T00:00:00Z","timestamp":1733875200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Kidney Disease and Transplant Center"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Chronic kidney disease (CKD) is a significant risk factor for cerebrovascular disease. However, there is limited research on how successful living donor kidney transplantation (LDKT) affects cerebral blood flow (CBF). This study aims to comprehensively investigate how LDKT influences CBF across various brain levels and regions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data from 53 recipients between 2016 and 2020 were obtained from the VINTAGE study conducted at our hospital. CBF was measured by level and region using single-photon emission computed tomography (SPECT), according to the Talairach brain atlas. The primary endpoint was the mean difference in CBF before and 1-year post-LDKT. Subgroup analysis using traditional risk factors assessed the heterogeneity of the effect on CBF in the frontal lobe region.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>LDKT improved blood flow in the anterior cerebral artery and middle cerebral artery but had less impact on the posterior cerebral artery. The most consistent improvements were observed in the frontal lobe region {left frontal lobe: \u22120.12 [95% confidence interval (CI) \u22120.18 to \u22120.05], P\u00a0&amp;lt;\u00a0.001; right frontal lobe: \u22120.13 [95% CI \u22120.21 to \u22120.05], P\u00a0=\u00a0.001}. Subgroup analysis showed a consistent effect of LDKT on frontal lobe CBF improvement, with no qualitative interaction observed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>LDKT contributes to the normalization of CBF, with improvement in anterior circulation and frontal lobe blood flow. To clarify the clinical significance of KT's CBF-improving effect, future studies should investigate the relationship between specific cognitive impairments (e.g. short-term memory, visuospatial ability, executive function) and CBF in each perfusion region.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ckj\/sfae392","type":"journal-article","created":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T03:09:52Z","timestamp":1733886592000},"source":"Crossref","is-referenced-by-count":4,"title":["Cerebral blood flow following successful living kidney transplantation: the VINTAGE study"],"prefix":"10.1093","volume":"18","author":[{"given":"Shuzo","family":"Kobayashi","sequence":"first","affiliation":[{"name":"Kidney Disease and Transplant Center, Shonan Kamakura General Hospital , Kanagawa ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1576-0868","authenticated-orcid":false,"given":"Sumi","family":"Hidaka","sequence":"additional","affiliation":[{"name":"Kidney Disease and Transplant Center, Shonan Kamakura General Hospital , Kanagawa ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunari","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Kidney Transplant and Robotic Surgery Center, Shonan Kamakura General Hospital , Kanagawa ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the VINTAGE Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mizuki","family":"Yamano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Mochida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suguru","family":"Muraoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayaka","family":"Mitomo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruka","family":"Maruyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunihiro","family":"Ishioka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Machiko","family":"Oka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidekazu","family":"Moriya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayasu","family":"Ohtake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuzo","family":"Kobayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunari","family":"Tanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Midori","family":"Imai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satomi","family":"Uchida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Midori","family":"Yonemura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsunori","family":"Shimada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumi","family":"Hidaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,12,10]]},"reference":[{"key":"2025020409402111000_bib1","doi-asserted-by":"publisher","first-page":"2154","DOI":"10.1161\/01.CIR.0000095676.90936.80","article-title":"Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention","volume":"108","author":"Sarnak","year":"2003","journal-title":"Circulation"},{"key":"2025020409402111000_bib2","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1053\/j.ajkd.2004.03.026","article-title":"Asymptomatic cerebral lacunae in patients with chronic kidney disease","volume":"44","author":"Kobayashi","year":"2004","journal-title":"Am J Kidney Dis"},{"key":"2025020409402111000_bib3","doi-asserted-by":"publisher","first-page":"1507","DOI":"10.1161\/CIRCULATIONAHA.122.060700","article-title":"Mild-to-moderate kidney dysfunction and cardiovascular disease: observational and Mendelian randomization analyses","volume":"146","author":"Gaziano","year":"2022","journal-title":"Circulation"},{"key":"2025020409402111000_bib4","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1093\/ckj\/sfv136","article-title":"Modulation of stroke risk in chronic kidney disease","volume":"9","author":"Arnold","year":"2016","journal-title":"Clin Kidney J"},{"key":"2025020409402111000_bib5","first-page":"89","article-title":"Cognitive function and advanced kidney disease: longitudinal trends and impact on decision-making","volume":"10","author":"Iyasere","year":"2017","journal-title":"Clin Kidney J"},{"key":"2025020409402111000_bib6","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s41100-024-00531-5","article-title":"Annual dialysis data report 2020, JSDT renal data registry","volume":"10","author":"Hanafusa","year":"2024","journal-title":"Ren Replace Ther"},{"key":"2025020409402111000_bib7","doi-asserted-by":"publisher","first-page":"2093","DOI":"10.1111\/j.1600-6143.2011.03686.x","article-title":"Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes","volume":"11","author":"Tonelli","year":"2011","journal-title":"Am J Transplant"},{"key":"2025020409402111000_bib8","doi-asserted-by":"publisher","first-page":"1090","DOI":"10.2215\/CJN.03080707","article-title":"Variations in the risk for cerebrovascular events after kidney transplant compared with experience on the waiting list and after graft failure","volume":"3","author":"Lentine","year":"2008","journal-title":"Clin J Am Soc Nephrol"},{"key":"2025020409402111000_bib9","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1681\/ASN.2018050462","article-title":"Investigating the relationship between cerebral blood flow and cognitive function in hemodialysis patients","volume":"30","author":"Findlay","year":"2019","journal-title":"J Am Soc Nephrol"},{"key":"2025020409402111000_bib10","doi-asserted-by":"publisher","first-page":"3275","DOI":"10.1093\/ndt\/gfl385","article-title":"Cognitive functioning pre- to post-kidney transplantation\u2014a prospective study","volume":"21","author":"Griva","year":"2006","journal-title":"Nephrol Dial Transplant"},{"key":"2025020409402111000_bib11","doi-asserted-by":"publisher","first-page":"sfae114","DOI":"10.1093\/ckj\/sfae114","article-title":"Cognitive decline related to chronic kidney disease as an exclusion factor from kidney transplantation: results from an international survey","volume":"17","author":"Farisco","year":"2024","journal-title":"Clin Kidney J"},{"key":"2025020409402111000_bib12","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1038\/hr.2014.57","article-title":"The effects of blood pressure and the renin-angiotensin-aldosterone system on regional cerebral blood flow and cognitive impairment in dialysis patients","volume":"37","author":"Kobayashi","year":"2014","journal-title":"Hypertens Res"},{"key":"2025020409402111000_bib13","first-page":"1579","article-title":"An automated method for rotational correction and centering of three-dimensional functional brain images","volume":"33","author":"Minoshima","year":"1992","journal-title":"J Nucl Med"},{"key":"2025020409402111000_bib14","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1007\/BF02988523","article-title":"Development of quantitative analysis method for stereotactic brain image: assessment of reduced accumulation in extent and severity using anatomical segmentation","volume":"17","author":"Mizumura","year":"2003","journal-title":"Ann Nucl Med"},{"key":"2025020409402111000_bib15","doi-asserted-by":"publisher","first-page":"3261","DOI":"10.1113\/jphysiol.2012.228551","article-title":"Regional brain blood flow in man during acute changes in arterial blood gases","volume":"590","author":"Willie","year":"2012","journal-title":"J Physiol"},{"key":"2025020409402111000_bib16","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1161\/01.STR.25.1.17","article-title":"Estimation of cerebral blood flow through color duplex sonography of the carotid and vertebral arteries in healthy adults","volume":"25","author":"Schoning","year":"1994","journal-title":"Stroke"},{"key":"2025020409402111000_bib17","doi-asserted-by":"publisher","first-page":"1032","DOI":"10.34067\/KID.0000000000000473","article-title":"Effect of tacrolimus levels on cerebral blood flow and cognitive function: a pilot study","volume":"5","author":"Tariq","year":"2024","journal-title":"Kidney360"},{"key":"2025020409402111000_bib18","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1111\/j.1600-6143.2006.01727.x","article-title":"Anemia is associated with mortality in kidney-transplanted patients\u2014a prospective cohort study","volume":"7","author":"Molnar","year":"2007","journal-title":"Am J Transplant"},{"key":"2025020409402111000_bib19","doi-asserted-by":"publisher","first-page":"1296","DOI":"10.1038\/jcbfm.2010.13","article-title":"Interindividual variations of cerebral blood flow, oxygen delivery, and metabolism in relation to hemoglobin concentration measured by positron emission tomography in humans","volume":"30","author":"Ibaraki","year":"2010","journal-title":"J Cereb Blood Flow Metab"},{"key":"2025020409402111000_bib20","doi-asserted-by":"crossref","first-page":"viii7","DOI":"10.1093\/ndt\/gfg1084","article-title":"The cardio-renal anaemia syndrome: does it exist?","volume":"18","author":"Silverberg","year":"2003","journal-title":"Nephrol Dial Transplant"},{"key":"2025020409402111000_bib21","first-page":"10972","article-title":"Chronic kidney disease causes blood-brain barrier breakdown via urea-activated matrix metalloproteinase-2 and insolubility of tau protein","volume":"15","author":"Matsuki","year":"2023","journal-title":"Aging (Albany NY)"},{"key":"2025020409402111000_bib22","doi-asserted-by":"publisher","first-page":"1316","DOI":"10.1056\/NEJMra071313","article-title":"Uremia","volume":"357","author":"Meyer","year":"2007","journal-title":"N Engl J Med"},{"key":"2025020409402111000_bib23","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1093\/ckj\/sfx091","article-title":"Chronic kidney disease, kidney transplantation and oxidative stress: a new look to successful kidney transplantation","volume":"11","author":"Tabriziani","year":"2018","journal-title":"Clin Kidney J"},{"key":"2025020409402111000_bib24","doi-asserted-by":"publisher","first-page":"1779","DOI":"10.1016\/j.jacc.2015.08.023","article-title":"Reverse remodeling and prognosis following kidney transplantation in contemporary patients with cardiac dysfunction","volume":"66","author":"Hawwa","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2025020409402111000_bib25","doi-asserted-by":"publisher","first-page":"2530","DOI":"10.1161\/hs1101.098360","article-title":"Cerebral blood flow in patients with chronic heart failure before and after heart transplantation","volume":"32","author":"Gruhn","year":"2001","journal-title":"Stroke"},{"key":"2025020409402111000_bib26","doi-asserted-by":"publisher","first-page":"1527","DOI":"10.1016\/j.jacc.2008.07.051","article-title":"Cardiorenal syndrome","volume":"52","author":"Ronco","year":"2008","journal-title":"J Am Coll Cardiol"},{"key":"2025020409402111000_bib27","doi-asserted-by":"publisher","first-page":"405","DOI":"10.2215\/CJN.08210815","article-title":"eGFR and outcomes in patients with acute decompensated heart failure with or without elevated BUN","volume":"11","author":"Kajimoto","year":"2016","journal-title":"Clin J Am Soc Nephrol"},{"key":"2025020409402111000_bib28","doi-asserted-by":"publisher","first-page":"161","DOI":"10.3390\/toxins12030161","article-title":"Cardiac remodeling in chronic kidney disease","volume":"12","author":"Kaesler","year":"2020","journal-title":"Toxins (Basel)"},{"key":"2025020409402111000_bib29","first-page":"161","article-title":"Cerebral autoregulation","volume":"2","author":"Paulson","year":"1990","journal-title":"Cerebrovasc Brain Metab Rev"},{"key":"2025020409402111000_bib30","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1016\/S1474-4422(14)70026-2","article-title":"Stroke and cerebrovascular diseases in patients with chronic kidney disease","volume":"13","author":"Toyoda","year":"2014","journal-title":"Lancet Neurol"},{"key":"2025020409402111000_bib31","doi-asserted-by":"publisher","first-page":"e328","DOI":"10.1161\/STROKEAHA.120.029680","article-title":"Chronic kidney disease and cerebrovascular disease: consensus and guidance from a KDIGO Controversies Conference","volume":"52","author":"Kelly","year":"2021","journal-title":"Stroke"},{"key":"2025020409402111000_bib32","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1681\/ASN.2020050584","article-title":"Normalization of cerebral blood flow, neurochemicals, and white matter integrity after kidney transplantation","volume":"32","author":"Lepping","year":"2021","journal-title":"J Am Soc Nephrol"},{"key":"2025020409402111000_bib33","doi-asserted-by":"publisher","first-page":"1910","DOI":"10.1093\/ndt\/gfm051","article-title":"Kidney dysfunction as a risk factor for first symptomatic stroke events in a general Japanese population\u2014the Ohasama study","volume":"22","author":"Nakayama","year":"2007","journal-title":"Nephrol Dial Transplant"},{"key":"2025020409402111000_bib34","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment","volume":"53","author":"Nasreddine","year":"2005","journal-title":"J Am Geriatr Soc"}],"container-title":["Clinical Kidney Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ckj\/advance-article-pdf\/doi\/10.1093\/ckj\/sfae392\/61025714\/sfae392.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ckj\/article-pdf\/18\/1\/sfae392\/61025714\/sfae392.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ckj\/article-pdf\/18\/1\/sfae392\/61025714\/sfae392.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T09:40:39Z","timestamp":1738662039000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ckj\/article\/doi\/10.1093\/ckj\/sfae392\/7920792"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,10]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1,7]]}},"URL":"https:\/\/doi.org\/10.1093\/ckj\/sfae392","relation":{},"ISSN":["2048-8505","2048-8513"],"issn-type":[{"value":"2048-8505","type":"print"},{"value":"2048-8513","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,1]]},"published":{"date-parts":[[2024,12,10]]},"article-number":"sfae392"}}