Key result
Stage III-IV CKD is not associated with impaired dynamic cerebral autoregulation versus matched controls.
Why the study?
Chronic kidney disease patients have an elevated risk for cerebrovascular disease, and impairment in dynamic cerebral autoregulation may contribute to this risk.
Is dynamic cerebral autoregulation impaired in patients with CKD stages III-IV compared to matched controls?
Case-Control (n=35)
Is dynamic cerebral autoregulation impaired in patients with CKD stages III-IV compared to matched controls?
p-value: p=≥0.12
Dynamic cerebral autoregulation remains intact in patients with CKD stages III-IV, suggesting other mechanisms drive their increased cerebrovascular disease risk.
Preserved dynamic cerebral autoregulation in CKD stages III-IV does not support targeted interventions; leaves open alternative mechanisms for elevated cerebrovascular risk.
Chronic Kidney Disease (CKD) patients experience an elevated risk for cerebrovascular disease. One factor that may contribute to this heightened risk is an impairment in dynamic cerebral autoregulation, the mechanism by which cerebral vessels modulate cerebral blood flow during fluctuations in arterial pressure. We hypothesized that dynamic cerebral autoregulation would be impaired in CKD. To test this hypothesis, we compared dynamic cerebral autoregulation between CKD patients stages III-IV and matched controls (CON) without CKD. Fifteen patients with CKD and 20 CON participants performed 2, 5-minute bouts of repeated sit-to-stand maneuvers at 0.05 Hz and 0.10 Hz while mean arterial pressure (MAP, via finger photoplethysmography) and middle cerebral artery blood velocity (MCAv, via transcranial Doppler ultrasound) were measured continuously. Cerebral autoregulation was characterized by performing a transfer function analysis (TFA) on the MAP-MCAv relationship to derive coherence, phase, gain, and normalized gain (nGain). We observed no group differences in any of the TFA metrics during the repeated sit-to-stand maneuvers. During the 0.05 Hz maneuver, Coherence: CKD = 0.83 ± 0.13, CON = 0.85 ± 0.12, Phase (radians): CKD = 1.39 ± 0.41, CON = 1.25 ± 0.30, Gain (cm/s/mmHg): CKD = 0.69 ± 0.20, CON = 0.71 ± 0.22, nGain (%/mmHg): CKD = 1.26 ± 0.35, CON = 1.20 ± 0.28, p ≥ 0.24. During the 0.10 Hz maneuver (N = 6 CKD and N = 12 CON), Coherence: CKD = 0.61 ± 0.10, CON = 0.67 ± 0.11, Phase (radians): CKD = 1.43 ± 0.26, CON = 1.30 ± 0.23, Gain (cm/s/mmHg): CKD = 0.75 ± 0.15, CON = 0.84 ± 0.26, nGain (%/mmHg): CKD = 1.50 ± 0.28, CON = 1.29 ± 0.24, p ≥ 0.12. Contrary to our hypothesis, dynamic cerebral autoregulation remains intact in CKD stages III-IV. These findings suggest that other mechanisms likely contribute to the increased cerebrovascular disease burden experienced by this population. Future work should determine if other cerebrovascular regulatory mechanisms are impaired and related to cerebrovascular disease risk in CKD.
No takes yet. Share an insight, caveat, or question.
Sprick et al. (2022) conducted a case-control in Chronic Kidney Disease (n=35). Chronic Kidney Disease stages III-IV vs. Matched controls without CKD was evaluated on Dynamic cerebral autoregulation metrics (coherence, phase, gain, normalized gain) during sit-to-stand maneuvers (p=≥0.12). Chronic kidney disease stages III-IV was not associated with impaired dynamic cerebral autoregulation compared to matched controls across all transfer function metrics (all p ≥ 0.12).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: