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Cerebral microbleeds and cognitive decline in a hemodialysis patient: Case report and review of literature
Author(s) -
Li Lin,
Fisher Mark,
Lau WeiLing,
Moradi Hamid,
Cheung Alexander,
Thai Gaby,
Handwerker Jason,
KalantarZadeh Kamyar
Publication year - 2015
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/hdi.12210
Subject(s) - medicine , hemodialysis , cerebral amyloid angiopathy , kidney disease , population , cognitive decline , stroke (engine) , end stage renal disease , cardiology , dementia , disease , mechanical engineering , environmental health , engineering
Cerebral microbleeds ( CMB s) are small hemosiderin deposits indicative of prior cerebral microscopic hemorrhage and previously thought to be clinically silent. Recent population‐based cross‐sectional studies and prospective longitudinal cohort studies have revealed association between CMB and cognitive dysfunction. In the general population, CMB s are associated with age, hypertension, and cerebral amyloid angiopathy. In the chronic kidney disease ( CKD ) population, diminished estimated glomerular filtration rate has been found to be an independent risk factor for CMB , raising the possibility that a uremic milieu may predispose to microbleeds. In the end‐stage renal disease ( ESRD ) population on hemodialysis, the incidence of microbleeds is significantly higher compared with a control group without history of CKD or stroke. We present an ESRD patient on chronic hemodialysis with a history of gradual cognitive decline and progressive CMBs. Through this case and literature review, we illustrate the need to develop detection and prediction models to treat this frequent development in ESRD patients.