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<p>End-stage renal disease (ESRD) is associated with an increased risk. This study investigates associations between cognitive decline, resting-state networks (RSNs), and biochemical indicators in ESRD patients pre-/post-hemodialysis. 20 hemodialysis (HD) patients and 22 healthy controls underwent resting-state fMRI (rs-fMRI) and neuropsychological assessments. Resting-state networks (RSNs) were extracted via independent component analysis (ICA), with functional connectivity strength compared between pre-/post-HD patients and controls. Correlations between connectivity strength and biochemical indicators were analyzed. Compared to HCs, the post-HD group exhibited significantly decreased FC between the auditory–somatomotor network (t = − 5.120, <i>P</i> &lt; 0.001) and the visual–somatomotor network (t = − 4.199, <i>P</i> &lt; 0.001). In contrast, FC between the default mode and dorsal attention networks was significantly increased (t = 2.908, <i>P</i> = 0.006). While serum electrolytes and iron metabolism markers remained stable post-HD (all <i>P</i> &gt; 0.05), phosphorus levels decreased (<i>P</i> = 0.046), with significant improvements in renal function: eGFR increased from 4.560 ± 1.650 to 16.980 ± 6.428 mL/min, urea, creatinine, and PTH levels decreased (all <i>P</i> &lt; 0.001). Elevated baseline chloride levels were associated with reduced post-HD attention network connectivity (<i>r</i> = -0.758, <i>P</i> &lt; 0.001), while cognitive improvement correlated inversely with baseline connectivity (<i>r</i> = -0.619, <i>P</i> = 0.004) and positively with connectivity plasticity (<i>r</i> = 0.513, <i>P</i> = 0.021). Immediate post-HD changes in resting-state network connectivity were associated with biochemical status and cognitive performance, suggesting potential neural substrates of cognitive dysfunction in ESRD.</p>

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Resting-state fMRI reveals immediate hemodialysis-related changes in cognitive function and brain network connectivity in end-stage renal disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月5日

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  • Tingting Du,
  • Zhen Zeng,
  • Dingbo Guo,
  • Liuheng Liu,
  • Fangyuan Ou,
  • Jin Ma,
  • Hua Yang,
  • Lisha Nie,
  • Chengxuan Liu,
  • Cong Peng

摘要

End-stage renal disease (ESRD) is associated with an increased risk. This study investigates associations between cognitive decline, resting-state networks (RSNs), and biochemical indicators in ESRD patients pre-/post-hemodialysis. 20 hemodialysis (HD) patients and 22 healthy controls underwent resting-state fMRI (rs-fMRI) and neuropsychological assessments. Resting-state networks (RSNs) were extracted via independent component analysis (ICA), with functional connectivity strength compared between pre-/post-HD patients and controls. Correlations between connectivity strength and biochemical indicators were analyzed. Compared to HCs, the post-HD group exhibited significantly decreased FC between the auditory–somatomotor network (t = − 5.120, P < 0.001) and the visual–somatomotor network (t = − 4.199, P < 0.001). In contrast, FC between the default mode and dorsal attention networks was significantly increased (t = 2.908, P = 0.006). While serum electrolytes and iron metabolism markers remained stable post-HD (all P > 0.05), phosphorus levels decreased (P = 0.046), with significant improvements in renal function: eGFR increased from 4.560 ± 1.650 to 16.980 ± 6.428 mL/min, urea, creatinine, and PTH levels decreased (all P < 0.001). Elevated baseline chloride levels were associated with reduced post-HD attention network connectivity (r = -0.758, P < 0.001), while cognitive improvement correlated inversely with baseline connectivity (r = -0.619, P = 0.004) and positively with connectivity plasticity (r = 0.513, P = 0.021). Immediate post-HD changes in resting-state network connectivity were associated with biochemical status and cognitive performance, suggesting potential neural substrates of cognitive dysfunction in ESRD.