Cerebral Blood Flow in Chronic Kidney Disease

Abstract

The prevalence of mild cognitive impairment increases with age and is further exacerbated by chronic kidney disease (CKD). CKD is associated with (1) mild cognitive impairment, (2) impaired endothelial function, (3) impaired blood-brain barrier, (4) increased cerebral microhemorrhage burden, (5) increased cerebral blood flow (CBF), (6) impaired cerebral autoregulation, (7) impaired cerebrovascular reactivity, and (8) increased arterial stiffness. We report preliminary findings from our group that demonstrate altered cerebrovascular reactivity in a mouse model of CKD-associated vascular calcification. The CBF of CKD mice increased more quickly in response to hypercapnia (p < 0.05) but then decreased prematurely during hypercapnia challenge (p < 0.05). Together, these results indicate that altered kidney function can lead to alterations in the cerebral microvasculature, and hence brain health.

Keywords: Cerebral blood flow; Chronic kidney disease; Laser speckle contrast imaging; Speckle contrast; Vascular dysfunction; Vasomotor reactivity.

Fig. 1.

Differences in cerebral vascular reactivity between wild-type (“Normal”) and mice with uremic vascular calcification (“CKD”, chronic kidney disease). (A) Representative time traces of CBF changes in normal and CKD mice. (B) Although the maximum increase in CBF was similar for normal and CKD mice (left graph, Mann-Whitney test, p = 0.69), the CBF of CKD mice increased more quickly in response to hypercapnia (middle graph, p < 0.05) but then decreased prematurely during hypercapnia challenge (right graph, p < 0.05). Dashed lines indicate period of hypercapnia.