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Cerebral and renal hemodynamics: similarities, differences, and associations with chronic kidney disease and aortic hemodynamics

Hypertension Research volume 45, pages 1363–1372 (2022)Cite this article

Abstract

Elevated arterial pulsatility is a common risk factor for cerebrovascular disease and chronic kidney disease (CKD), which suggests that the brain and kidneys may have similar hemodynamic profiles. The objectives of this study were twofold: 1) to compare and contrast the cerebral and renal blood flow parameters in adults without CKD (hereafter, non-CKD adults) and CKD patients and 2) to determine the common predictor(s) of cerebral and renal hemodynamics among pressure pulsatility and several cardiovascular risk factors. In 110 non-CKD adults and 66 CKD patients, cerebral and renal blood flow velocity (BFV) were measured by transcranial Doppler and Duplex ultrasonography, respectively. Pulsatile hemodynamics were assessed by the pulsatility (PI) and resistive (RI) indices. Aortic pulse pressure was measured by tonometry. Compared with non-CKD adults, CKD patients showed greater pulsatility of the BFV (i.e., systolic minus diastolic BFV), PI, and RI in the kidneys but not the brain. However, the cerebral and renal PI and RI values were strongly correlated in both non-CKD adults (both PI and RI values: rs = 0.695) and CKD patients (both PI and RI values: rs = 0.640) (all P < 0.001). Multiple linear regression analysis further demonstrated that the cerebral and renal PI and RI associations remained significant after adjustment for potential covariates (e.g., age, sex, the presence of CKD). The aortic pulse pressure was a significant predictor for both cerebral and renal PI and RI values. Collectively, our findings suggest that CKD patients have higher renal flow pulsatility, which is strongly and independently associated with cerebral flow pulsatility and aortic hemodynamics.

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Acknowledgements

We thank each of the study participants for their effort and time in contributing to the study. Additionally, the authors are grateful to the members of our laboratory (University of Tsukuba) and Ms. Michiru Hotta (University of Tsukuba) for their technical assistance.

Funding

This work was supported in part by a Grant-in-Aid for Scientific Research KAKENHI from the Ministry of Education, Culture, Sports, Science, and Technology, Japan (grant number 19H03995) and the MEXT Leading Initiative for Excellent Young Researchers Grant Number JPMXS0320200234.

Author information

Authors and Affiliations

  1. Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan

    Keisei Kosaki, Takashi Tarumi, Jun Sugawara & Seiji Maeda

  2. Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Ibaraki, Japan

    Takashi Tarumi & Jun Sugawara

  3. Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan

    Shoya Mori & Masahiro Matsui

  4. Japan Society for the Promotion of Science, Tokyo, Japan

    Shoya Mori & Masahiro Matsui

  5. Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan

    Takeshi Sugaya

  6. Division of Anti-aging Medicine, Center for Molecular Medicine, Jichi Medical University, Tochigi, Japan

    Makoto Kuro-o

  7. Department of Nephrology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan

    Chie Saito & Kunihiro Yamagata

  8. R&D Center for Smart Wellness City Policies, University of Tsukuba, Ibaraki, Japan

    Kunihiro Yamagata

  9. Faculty of Sport Sciences, Waseda University, Saitama, Japan

    Koichiro Oka & Seiji Maeda

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  1. Keisei Kosaki
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  2. Takashi Tarumi
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  4. Masahiro Matsui
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  5. Jun Sugawara
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  6. Takeshi Sugaya
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  7. Makoto Kuro-o
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  11. Seiji Maeda
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Contributions

KK: Conceptualization, Investigation, Formal analysis, Writing - original draft, Funding acquisition, Project administration. TT: Conceptualization, Writing - review & editing. SM: Investigation. MM: Investigation. JS: Writing - review & editing. TS: Writing - review & editing. MK-o: Writing - review & editing. CS: Writing - review & editing. KY: Writing - review & editing. KO: Supervision, Writing - review & editing. SM: Funding acquisition, Supervision, Writing - review & editing.

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Correspondence to Seiji Maeda.

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Kosaki, K., Tarumi, T., Mori, S. et al. Cerebral and renal hemodynamics: similarities, differences, and associations with chronic kidney disease and aortic hemodynamics. Hypertens Res 45, 1363–1372 (2022). https://doi.org/10.1038/s41440-022-00944-x

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