| [ Summary ] |
Brain atrophy is known to progress more rapidly in dialysis patients through a mechanism which cannot be attributed to aging. The precise mechanisms remain unclear although the participation of arteriosclerosis in the brain due to dyslipidemia and hypertension, anemia, heart failure, aluminum toxicity, uremic toxins, and hemodialysis-related brain edema have all been considered as causative mechanisms related to brain atrophy. Cognitive dysfunction has also been shown to be highly prevalent in dialysis patients. These patients' conditions may improve following treatment for anemia with erythropoiesis-stimulating agents or renal transplantation. Frequent hemodialysis has not been shown to be effective. Thus, it is suggested that management of correctable risk factors such as hypertension, anemia, and dyslipidemia may be of profound importance in the prevention of brain atrophy and cognitive dysfunction. |