Abstract
【Objective】To examine the association between nutritional status and the severity of cerebral white matter lesions (WMLs) in dialysis patients. 【Methods】Subjects consisted of 28 patients with end-stage renal failure who underwent regular hemodialysis in the affiliated hospitals of Showa University Hospital. All subjects underwent brain MRI and various clinical and laboratory tests. All subjects were divided into three groups based on the following criteria. GroupI was defined as having 0 or 1 of the 4 findings of malnutrition (body mass index<18.5kg/mm2, total lymphocyte counts<1,500/mm3, serum albumin concentrations<3.5g/dL, normalized protein catabolic rate<0.9g/kg/day). GroupII was defined as having 2 of these 4 findings, and groupIII was defined as having 3 or all of these 4 findings. WMLs detected on T2-weightd MRI were rated using the semiquantitative method yielding two continuous variables (perivascular hyperintensity (PVH) scores, deep subcortical white matter hyperintensity (DSWMH) scores). 【Results】PVH and DSWMH scores were significantly higher in patients in groupsIII and II compared to that of those in groupI. Multiple regression analysis demonstrated that the four findings of malnourishment described above had significant impact on PVH and DSWMH scores.【Conclusion】These findings suggest that nutritional status (especially malnutrition) in dialysis patients may be involved in the severity of WMLs.
