{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T06:16:28Z","timestamp":1783664188224,"version":"3.55.0"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cognitive impairment is frequent in end-stage kidney disease (ESKD) patients, who also have brain structural changes and reduced regional cerebral oxygenation (rSO2). However, the relationship between these parameters remains insufficiently explored. The primary aim of this study was to compare cognition, brain structural changes and cerebral oxygenation between hemodialysis (HD) patients and healthy controls. The secondary aim was to assess the relationship between cerebral oxygenation, cognitive performance and brain morphometric parameters in HD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross-sectional study, we enrolled 44 HD patients (24 males, 20 females; mean age 72.5\u202f\u00b1\u202f17.5\u202fyears) and 24 healthy controls of similar age. All patients had received HD for more than three months. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Frontal lobe oxygenation was measured with the INVOS 5100C Oximetry system. Brain morphology was evaluated using MRI on a Magnetom Sola 1.5\u202fT scanner, processed with MorphoBox software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The HD group showed lower rSO2 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), worse cognitive scores (p\u202f&amp;lt;\u202f0.001), and significant brain structural changes including reduced white (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.005) and grey (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.002) matter volumes, more extensive white matter hyperintensities (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.04), microbleeds (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001), and lacunar infarcts (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.003). MoCA and rSO2 values were positively correlated in controls (Spearman rho\u202f=\u202f0.411,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.046), but not in HD patients. In the HD group, MoCA scores significantly correlated with brain structural parameters (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HD patients had impaired cognition, lower cerebral oxygenation, and marked structural brain changes. However, regional frontal cerebral hypoxia was not associated with cognitive decline or brain structural changes in HD patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1885904","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:39:03Z","timestamp":1783661943000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Structural brain changes, cerebral oxygenation, and cognitive function in hemodialysis patients: a cross-sectional study"],"prefix":"10.3389","volume":"13","author":[{"given":"Martin","family":"Michna","sequence":"first","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady","place":["Prague, Czechia"]},{"name":"Third Department of Internal Medicine, General University Hospital in Prague, First Faculty of Medicine, Charles University","place":["Prague, Czechia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romana","family":"Burgetova","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady","place":["Prague, Czechia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Kremenova","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady","place":["Prague, Czechia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Burgetova","sequence":"additional","affiliation":[{"name":"Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague","place":["Prague, Czechia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Krasensky","sequence":"additional","affiliation":[{"name":"Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague","place":["Prague, Czechia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiri","family":"Lukavsky","sequence":"additional","affiliation":[{"name":"Faculty of Arts, Charles University","place":["Prague, Czechia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbora","family":"Szonowska","sequence":"additional","affiliation":[{"name":"Fresenius Medical Care, Kralovske Vinohrady","place":["Prague, Czechia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Rychlik","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady","place":["Prague, Czechia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana","family":"Malikova","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady","place":["Prague, Czechia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Malik","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, General University Hospital in Prague, First Faculty of Medicine, Charles University","place":["Prague, Czechia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.33549\/physiolres.934420","article-title":"Review of the structural and functional brain changes associated with chronic kidney 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