• Mariana Schechtel Koch, Bianca Drewnowski, Cristiane Rickli, Fábio André Dos Santos, Gilberto Baroni, and José Carlos Rebuglio Vellosa.
• PhD Candidate, Biologist. Universidade Estadual de Ponta Grossa (UEPG), Ponta Grossa (PR), Brazil.
• Sao Paulo Med J. 2023 Jan 1; 142 (3): e2023068e2023068.

BackgroundAmong the complications related to chronic kidney disease (CKD), those of a neurological nature stand out, and for a better quality of life for patients, the diagnosis and treatment of these complications is fundamental.ObjectivesThis study aimed to assess the effect of hemodialysis on intracranial pressure waveform (ICPw) in patients with chronic kidney disease undergoing hemodialysis and those who are not yet undergoing substitutive therapy.Design And SettingAn observational study was conducted in two stages at a kidney replacement therapy center in Brazil. The first was a longitudinal study and the second was a cross-sectional study.MethodsForty-two patients on hemodialysis were included in the first stage of the study. In the second stage, 226 participants were included. Of these, 186 were individuals with chronic kidney disease (who were not undergoing substitutive therapy), and 40 did not have the disease (control group). The participants' intracranial compliance was assessed using the non-invasive Brain4care method, and the results were compared between the groups.ResultsThere was a significant difference between the hemodialysis and non-hemodialysis groups, with the former having better ICPw conditions.ConclusionsHemodialysis influenced the improvement in ICPw, probably due to the decrease in the patients' extra-and intracellular volumes. Furthermore, ICPw monitoring can be a new parameter to consider when defining the moment to start substitutive therapy.

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