Son evre kroni̇k böbrek yetmezli̇ği̇ olgularinda serebral mi̇krokanamanin nörokogni̇ti̇f fonksi̇yon bozukluğu üzeri̇ne etki̇si̇

Objective: To detect intracerebral microbleeding with Susceptibility Weighted Imaging (SWI) Magnetic Resonance Imaging (MRI) on hemodialysis (HD) patients and investigate relation between microbleeding and neurocognitive impairment. Material and Method: 49 hemodialysis cases with end stage renal disease (ESRD) were involved in this study. Existence and locations of microbleeding, relation between microbleeding and hypertension (HT), diabetes mellitus (DM), age and duration of dialysis were analyzed. Standardized mini-mental test (SMT) was performed for 43 cases excluding 6 cases who are have stroke history. Total test score was accepted as 30 points. Neurocognitive impairment was classified as severe (≤ 9 points), moderate (10-18 points) and mild (19-24 points) impairment. The tested cases divided two groups as cases with microbleeding (Group 1, n: 26) and without microbleeding (Group 2, n: 17) so that relation between intracerebral microbleeding and neurocognitive impairment was analyzed. Result: Incidence of microbleeding and macrohemorrhage was noted as % 59 and % 14 respectively in all cases. All macrohemorrhagic cases have also microbleeding. In group 1, neurocognitive impairment was detected in 10 cases (38,4%). 6 cases have moderate, 4 cases have mild impairment. In group 2, neurocognitive impairment was detected in 2 cases (11,7%). Both cases have mild impairment. Significant positive corelation was detected between microbleeding and cognitive regresion (p=0,031). Although there was no corelation between attention disorder which is important factor for test scoring and microbleeding, positive corelation was detected between close memory impairment and microbleeding (p=0,027). Positive corelation was detected between DM and microbleeding (p=0,027). Conclusion: In hemodialysis patients, microbleeding is the most important cause of neurocognitive impairment which is important for guide to treatment protocols. SWI MRI should be included at imaging protocol of diabetic hemodialysis patients with neurocognitive regresion. Keywords: Chronic Renal Failure, End Stage Renal Disease, Dialysis, SWI, Microbleeding