Creatinine accumulation may lead to increased interstitial fluid in patients with chronic kidney disease

Motivation: Chronic kidney disease (CKD) may lead to cognitive decline, which may be linked to glymphatic system dysfunction. However, the underlying pathophysiology remains unclear. Goal(s): This study aims to evaluate differences in interstitial fluid (ISF) between early and advanced CKD patients and healthy controls, and to investigate correlations between ISF, clinical laboratory indicators, and cognitive function. Approach: Spectral diffusion analysis was applied to measure the ISF fraction (fint). Results: CKD patients exhibited significantly higher fint compared to healthy controls. Furthermore, in the early-stage CKD group, fint in bilateral centrum semiovale was positively correlated with creatinine level and negatively correlated with MoCA score. Impact: A novel approach to measure ISF shows the potential for detecting brain glymphatic system function, which provides unique insights into the pathological mechanisms underlying cognitive decline in CKD patients.