Cerebral white matter burden is linked to cognitive function in patients undergoing hemodialysis

Figures & data

Figure 1. Fazekas scale of periventricular white matter hyperintensities in MRI examples.

Table 1. Baseline characteristics of hemodialysis participants stratified by Fazekas scale of periventricular white matter hyperintensities and deep white matter hyperintensities.

	Periventricular hyperintensities (Total N = 59)					Deep white matter hyperintensities (Total N = 59)
	Grade 0 N = 4	Grade 1 N = 23	Grade 2 N = 23	Grade 3 N = 9	p-value	Grade 0 N = 8	Grade 1 N = 19	Grade 2 N = 24	Grade 3 N = 8	p-value
Age (years)	41.8 ± 4.3	61.3 ± 11.6	65.1 ± 9.0	66.6 ± 6.9	<.001	56.0 ± 16.5	61.1 ± 10.9	64.6 ± 7.1	64.3 ± 14.6	.260
Male	2 (50.0%)	10 (43.5%)	14 (60.9%)	4 (44.4%)	.647	4 (50.0%)	8 (42.1%)	15 (62.5%)	3 (37.5%)	.522
Diabetes mellitus	3 (75.0%)	12 (52.2%)	17 (73.9%)	6 (66.7%)	.487	4 (50.0%)	10 (52.6%)	19 (79.2%)	5 (62.5%)	.210
Cerebrovascular disease	0 (0.0%)	5 (21.7%)	8 (34.8%)	2 (22.2%)	.596	1 (12.5%)	4 (21.1%)	7 (29.2%)	3 (37.5%)	.687
Hemoglobin (mg/dl)	11.2 ± 0.1	10.9 ± 1.2	10.7 ± 1.4	10.3 ± 0.9	.552	10.9 ± 0.5	10.5 ± 1.0	11.0 ± 1.5	10.4 ± 0.9	.558
Albumin (mg/dl)	3.9 ± 0.4	3.8 ± 0.2	3.9 ± 0.3	3.7 ± 0.3	.394	3.8 ± 0.4	3.8 ± 0.2	3.9 ± 0.2	3.8 ± 0.3	.884
Single pool Kt/V	1.4 ± 0.3	1.5 ± 0.2	1.5 ± 0.2	1.5 ± 0.2	.746	1.5 ± 0.2	1.6 ± 0.2	1.5 ± 0.2	1.5 ± 0.2	.289

Figure 2. The mean cognitive function test scores across the Fazekas scale of periventricular white matter hyperintensities and deep white matter hyperintensities. (A) Mini-mental State Examination (MMSE), (B) Montreal cognitive assessment (MoCA), and (C) The cognitive Abilities Screening Instrument (CASI).

Figure 3. The mean values of the cognitive Abilities Screening Instrument (CASI) subdomains across the Fazekas scale of (A) periventricular white matter hyperintensities and (B) deep white matter hyperintensities.

Table 2. Association between cognitive function score and Fazekas scale of periventricular white matter hyperintensities (PVWMHs) and deep white matter hyperintensities (DWMHs) in hemodialysis participants using ordinal regression analysis with confounders adjustment.

	Odds ratio (95% CI)
	Model 1	Model 2	Model 3
PVWMHs
MMSE	0.86 (0.76, 0.97)*	0.87 (0.77, 0.98)*	0.87 (0.76, 0.99)*
MoCA	0.84 (0.75, 0.93)*	0.86 (0.77, 0.95)*	0.86 (0.76, 0.97)*
CASI	0.95 (0.91, 0.98)*	0.95 (0.92, 0.98)*	0.95 (0.92, 0.99)*
Long term memory	0.86 (0.59, 1.25)	0.88 (0.60, 1.30)	0.94 (0.63, 1.40)
Short term memory	0.77 (0.65, 0.92)*	0.78 (0.64, 0.94)*	0.81 (0.66, 1.00)
Attention	0.77 (0.55, 1.06)	0.81 (0.57, 1.14)	0.87 (0.61, 1.25)
Mental manipulation	0.77 (0.63, 0.94)*	0.80 (0.65, 0.98)*	0.79 (0.63, 0.99)*
Orientation	0.90 (0.78, 1.04)	0.92 (0.79, 1.06)	0.91 (0.78, 1.07)
Abstract thinking	0.69 (0.56, 0.85)*	0.71 (0.57, 0.90)*	0.70 (0.54, 0.92)*
Language	0.72 (0.54, 0.96)*	0.74 (0.55, 1.00)	0.76 (0.55, 1.06)
Spatial construction	0.81 (0.69, 0.94)*	0.79 (0.67, 0.93)*	0.78 (0.64, 0.94)*
Name fluency	0.75 (0.59, 0.94)*	0.80 (0.63, 1.01)	0.77 (0.59, 1.01)
DWMHs
MMSE	0.91 (0.82, 1.01)	0.92 (0.82, 1.02)	0.89 (0.79, 1.01)
MoCA	0.93 (0.85, 1.02)	0.95 (0.86, 1.04)	0.91 (0.81, 1.03)
CASI	0.97 (0.94, 1.00)	0.97 (0.94, 1.00)	0.96 (0.93, 1.00)
Long term memory	0.92 (0.63, 1.34)	0.95 (0.65, 1.40)	1.00 (0.67, 1.48)
Short term memory	0.81 (0.69, 0.96)*	0.82 (0.68, 0.98)*	0.77 (0.63, 0.95)*
Attention	0.92 (0.66, 1.26)	0.97 (0.69, 1.35)	1.01 (0.71, 1.44)
Mental manipulation	0.88 (0.73, 1.06)	0.90 (0.74, 1.09)	0.92 (0.74, 1.14)
Orientation	0.88 (0.76, 1.02)	0.89 (0.77, 1.03)	0.88 (0.75, 1.04)
Abstract thinking	0.83 (0.69, 1.01)	0.86 (0.70, 1.06)	0.85 (0.67, 1.09)
Language	0.87 (0.67, 1.13)	0.89 (0.68, 1.18)	0.86 (0.62, 1.18)
Spatial construction	0.88 (0.76, 1.02)	0.88 (0.75, 1.02)	0.83 (0.69, 1.00)
Name fluency	0.89 (0.72, 1.10)	0.93 (0.74, 1.17)	0.86 (0.67, 1.11)

Model 1: crude model.

Model 2: adjusted for age, sex.

Model 3: adjusted for age, sex, comorbidity (diabetes mellitus and cerebrovascular disease), and clinical laboratory data (hemoglobin, albumin, and Kt/V).

*p < .05.

Data availability statement

The data will be provided upon request to the corresponding author.