Background And Objectives: Cognition in ESRD may be improved by kidney transplantation, but mechanisms are unclear. We explored patterns of resting-state networks with resting-state functional magnetic resonance imaging among patients with ESRD before and after kidney transplantation.
Design, Setting, Participants, & Measurements: Thirty-seven patients with ESRD scheduled for kidney transplantation and 22 age-, sex-, and education-matched healthy subjects underwent resting-state functional magnetic resonance imaging. Patients were imaged before and 1 and 6 months after kidney transplantation. Functional connectivity of seven resting-state subnetworks was evaluated: default mode network, dorsal attention network, central executive network, self-referential network, sensorimotor network, visual network, and auditory network. Mixed effects models tested associations of ESRD, kidney transplantation, and neuropsychological measurements with functional connectivity.
Results: Compared with controls, pretransplant patients showed abnormal functional connectivity in six subnetworks. Compared with pretransplant patients, increased functional connectivity was observed in the default mode network, the dorsal attention network, the central executive network, the sensorimotor network, the auditory network, and the visual network 1 and 6 months after kidney transplantation (=0.01). Six months after kidney transplantation, no significant difference in functional connectivity was observed for the dorsal attention network, the central executive network, the auditory network, or the visual network between patients and controls. Default mode network and sensorimotor network remained significantly different from those in controls when assessed 6 months after kidney transplantation. A relationship between functional connectivity and neuropsychological measurements was found in specific brain regions of some brain networks.
Conclusions: The recovery patterns of resting-state subnetworks vary after kidney transplantation. The dorsal attention network, the central executive network, the auditory network, and the visual network recovered to normal levels, whereas the default mode network and the sensorimotor network did not recover completely 6 months after kidney transplantation. Neural resting-state functional connectivity was lower among patients with ESRD compared with control subjects, but it significantly improved with kidney transplantation. Resting-state subnetworks exhibited variable recovery, in some cases to levels that were no longer significantly different from those of normal controls.
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http://dx.doi.org/10.2215/CJN.00420117 | DOI Listing |
Andes Pediatr
August 2023
Fundación Valle del Lili, Cali, Colombia.
Advances in the field of genetics and genomics have had a great impact on the clinical practice of the pediatric nephrologist. Access to diagnostic genetic studies for renal pathologies allows not only to confirm specific diagnoses, but also to provide management and follow-up strategies, knowledge about prognosis, and prevention of complications. In addition, it provides genetic counseling to the patient and family and even helps to make decisions about family donor transplantation.
View Article and Find Full Text PDFBiometrics
January 2025
School of Statistics and Management, Shanghai University of Finance and Economics, Shanghai 200433, China.
As a commonly employed method for analyzing time-to-event data involving functional predictors, the functional Cox model assumes a linear relationship between the functional principal component (FPC) scores of the functional predictors and the hazard rates. However, in practical scenarios, such as our study on the survival time of kidney transplant recipients, this assumption often fails to hold. To address this limitation, we introduce a class of high-dimensional partially linear functional Cox models, which accommodates the non-linear effects of functional predictors on the response and allows for diverging numbers of scalar predictors and FPCs as the sample size increases.
View Article and Find Full Text PDFPediatr Nephrol
January 2025
Nephrology, Children's National Hospital, 111 Michigan Avenue NW, Washington, DC, 20010, USA.
Background: Obesity and metabolic syndrome (MS) accelerate arterial stiffening, increasing cardiovascular (CV) risk after transplant. BMI is limited by inability to differentiate muscle, fat mass, and fat distribution patterns. The aim of this study was to identify the best anthropometric measure to detect arterial stiffness as assessed by pulse wave velocity (PWV) in a racially diverse pediatric transplant population.
View Article and Find Full Text PDFCochrane Database Syst Rev
January 2025
Cochrane Kidney and Transplant, Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia.
Background: Cytomegalovirus (CMV) is a significant cause of morbidity and death in solid organ transplant recipients. Pre-emptive treatment of patients with CMV viraemia using antiviral agents has been suggested as an alternative to routine prophylaxis to prevent CMV disease. This is an update of a Cochrane review first published in 2006 and updated in 2013.
View Article and Find Full Text PDFClin Case Rep
January 2025
Department of Surgical Oncology, Erasmus MC Cancer Institute Erasmus University Medical Center Rotterdam The Netherlands.
Soft tissue sarcomas (STSs) are rare malignancies, with retroperitoneal soft tissue sarcoma (RPS) constituting 10%-15% of all STSs. RPS often presents late due to minimal early symptoms, typically requiring complete en-bloc resection for optimal survival outcomes. Achieving radical resection can be challenging due to the tumor's proximity to vital organs.
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