AUTHOR=Heo Chang Min , Lee Won Ho , Park Bong Soo , Lee Yoo Jin , Park Sihyung , Kim Yang Wook , Lee Dong Ah , Yoo Byeong Cheol , Park Kang Min 

TITLE=Glymphatic Dysfunction in Patients With End-Stage Renal Disease

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.809438

DOI=10.3389/fneur.2021.809438

ISSN=1664-2295

ABSTRACT=Background:  We aimed to compare glymphatic dysfunction between patients with end-stage renal disease (ESRD) and healthy controls, and analyze the correlation between glymphatic function and clinical characteristics using the diffusion tensor image analysis along the perivascular space (DTI-ALPS) index.
Methods: We prospectively enrolled neurologically asymptomatic 49 patients with ESRD undergoing dialysis and 38 healthy controls. DTI was conducted using the same 3T scanner, and the DTI-ALPS index was calculated. We compared the DTI-ALPS index between the ESRD patients and healthy controls. In addition, we conducted a correlation analysis between the clinical characteristics and DTI-ALPS index in ESRD patients. 
Results: There were significant differences in the DTI-ALPS index between patients with ESRD and healthy controls. The DTI-ALPS index in patients with ESRD was lower than that in healthy controls (1.460 vs. 1.632, p=0.003). In addition, there was a significant positive correlation between the DTI-ALPS index and serum parathyroid hormone levels (r=0.357, p=0.011).
Conclusion: We demonstrated glymphatic dysfunction in patients with ESRD, as revealed by the DTI-ALPS index. Our study also reveals the feasibility of the DTI-ALPS method to determine glymphatic function in patients with ESRD, which could be used in the future researches.