Blood Purification

Hemodialysis – Research Article

The Incidence Prognosis and Risk Factors of Cognitive Impairment in Maintenance Haemodialysis Patients

Lu R.a,b · Xu C.a · Li Y.c · Yu L.c · Shao X.a · Xie K.a · Gu J.a · Yu Z.a · Yan Y.a · Guan Y.c · Ni Z.a · Ronco C.b · Gu L.a

Author affiliations

aDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
bNephrology, Dialysis and Transplantation of the San Bortolo Hospital in Vicenza, and the International Renal Research Institute of Vicenza (IRRIV), Vicenza, Italy
cDepartment of Neurology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

Keywords: End-stage renal diseaseComplicationEducation statusBlood pressureSpKt/V

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Blood Purif 2019;47:101–108
https://doi.org/10.1159/000493524

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Article / Publication Details

First-Page Preview
Abstract of Hemodialysis – Research Article

Received: August 13, 2018
Accepted: September 06, 2018
Published online: September 25, 2018
Issue release date: February 2019

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 4

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

Abstract

Objective: To investigate the incidence and the prognosis of cognitive impairment (CI) and to find out the risk factors associated with the outcome in maintenance haemodialysis (MHD) patients. Methods: Enrolled the patients who met the criteria as below: MHD (≥3 months) patients before July 2014, ≥18 years old and could carry on the cognitive function test (Montreal Cognitive Assessment [MoCA]). All enrolled patients were divided into 2 groups: CI group (MoCA < 26) and non-CI group (MoCA ≥26). All patients were followed up for 36 months. The incidence, demography data, medical history, haemodialysis data, laboratory examination and prognosis of CI in haemodialysis patients were prospectively compared and analyzed. Multivariate logistic regression analysis was used to investigate the risk factors of CI. Kaplan-Meier survival curve was used for survival analysis. Results: In the present study, 219 patients were enrolled. The ratio of male to female was 1.46: 1. Age was 60.07 ± 12.44 and dialysis vintage was 100.79 ± 70.23 months. One hundred thirteen patients’ MoCA scores were lower than 26 were divided into CI group. Education status (OR 3.428), post-dialysis diastolic pressure (OR 2.234) and spKt/V (OR 1.982) were independent risk factors for CI in MHD patients. During the follow-up period, 15 patients died (13.2%) in the CI group and 5 died (4.72%) in the non-CI group (p < 0.05). The Kaplan-Meier survival curve analysis showed that the survival rate of patients with CI was lower than that of non-CI group in MHD patients during 3 years follow-up (p = 0.046). Conclusion: CI is one of the most common complications in MHD patients. The mortality is high in patients who had CI. Education status, post-dialysis diastolic pressure and spKt/V are independent risk factors for CI in MHD patients.

© 2018 S. Karger AG, Basel



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References

  1. Unite State Renal Data System (USRDS) Annual Report, 2015.
  2. Shanghai Dialysis Registration Annual Report, 2015.
  3. Kurella Tamura M, Yaffe K: Dementia and cognitive impairment in ESRD: diagnostic and therapeutic strategies. Kidney Int 2011; 79: 14–22.
  4. Kalirao P, Pederson S, Foley RN, et al: Cognitive impairment in peritoneal dialysis patients. Am J Kidney Dis 2011; 57: 612–620.
  5. La Greca G, Dettori P, Biasioli S, Fabris A, Feriani M, Pinna V, Pisani E, Ronco C: Brain density studies during dialysis. Lancet 1980; 2: 582.
  6. Lu R, Kiernan MC, Murray A, Rosner MH, Ronco C: Kidney-brain crosstalk in the acute and chronic setting. Nat Rev Nephrol 2015,11: 707–719.
  7. Lupica R, Donato V, Lacquaniti A, et al: Proteinuric effect of transcranial magnetic stimulation in healthy subjects and diabetic patients with stage 3–4 CKD. Nephrol Dial Transplant 2014; 29: 573–579.
  8. Krishnan AV, Kiernan MC: Neurological complications of chronic kidney disease. Nat Rev Neurol 2009; 5: 542–551.
  9. Nasreddine ZS, Phillips NA, Bedirian V, et al: The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53: 695–699.
  10. Drew DA, Tighiouart H, Scott TM, et al: Cognitive performance before and during hemodialysis: a randomized cross-over trial. Nephron Clin Pract 2013; 124: 151–158.
  11. Drew DA, Weiner DE, Tighiouart H, et al: Cognitive decline and its risk factors in prevalent hemodialysis patients. Am J Kidney Dis 2017; 69: 780–787.
  12. Griva K, Stygall J, Hankins M, Davenport A, Harrison M, Newman SP: Cognitive impairment and 7-year mortality in dialysis patients. Am J Kidney Dis 2010; 56: 693–703.
  13. Weiner DE, Scott TM, Giang LM, et al: Cardiovascular disease and cognitive function in maintenance hemodialysis patients. Am J Kidney Dis 2011; 58: 773–781.
  14. Sarnak MJ, Tighiouart H, Scott TM, et al: Frequency of and risk factors for poor cognitive performance in hemodialysis patients. Neurology 2013; 80: 471–480.
  15. Dasgupta I, Patel M, Mohammed N, et al: Cognitive function declines significantly during haemodialysis in a majority of patients: a call for further research. Blood Purif 2018; 45: 347–355.
  16. Siebert JS, Wahl HW, Degen C, Schröder J: Attitude toward own aging as a risk factor for cognitive disorder in old age: 12-year evidence from the ILSE study. Psychol Aging 2018; 33: 461–472.
  17. Mortamais M, Portet F, Brickman AM, et al: Education modulates the impact of white matter lesions on the risk of mild cognitive impairment and dementia. Am J Geriatr Psychiatry 2014; 22: 1336–1345.
  18. Johansson L, Thelle DS, Solvoll K, Bjørneboe GE, Drevon CA: Healthy dietary habits in relation to social determinants and lifestyle factors. Br J Nutr 1999; 81: 211–220.
  19. Valenzuela M, Sachdev P: Can cognitive exercise prevent the onset of dementia? Systematic review of randomized clinical trials with longitudinal follow-up. Am J Geriatr Psychiatry 2009; 17: 179–187.
  20. Asato MR, Terwilliger R, Woo J, Luna B: White matter development in adolescence: a DTI study. Cereb Cortex 2010; 20: 2122–2131.
  21. Odagiri G, Sugawara N, Kikuchi A, et al: Cognitive function among hemodialysis patients in Japan. Ann Gen Psychiatry 2011; 10: 20.
  22. Kurella Tamura M, Unruh ML, Nissenson AR, et al: Effect of more frequent hemodialysis on cognitive function in the frequent hemodialysis network trials. Am J Kidney Dis 2013; 61: 228–237.
  23. Murray AM, Tupper DE, Knopman DS, et al: Cognitive impairment in haemodialysis patients is common. Neurology 2006; 67: 216–223.
  24. Teschan PE: Electroencephalographic and other neurophysiological abnormalities in uremia. Kidney Int Suppl 1975; 2: 210–216.
  25. Napper AD, Hixon J, McDonagh T, et al: Discovery of indoles as potent and selective inhibitors of the deacetylase SIRT1. J Med Chem 2005; 48: 8045–8054.
  26. Chen CL, Lai PH, Chou KJ, Lee PT, Chung HM, Fang HC: A preliminary report of brain edema in patients with uremia at first hemodialysis: evaluation by diffusion-weighted MR Imaging. Am J Neuroradiol 2007; 28: 68–71.
  27. Jassal SV, Devins GM, Chan CT, Bozanovic R, Rourke S: Improvements in cognition in patients converting from thrice weekly haemodialysis to nocturnal haemodialysis: a longitudinal pilot study. Kidney Int 2006; 70: 956–962.
  28. Neumann D, Mau W, Wienke A, Girndt M: Peritoneal dialysis is associated with better cognitive function than hemodialysis over a one-year course. Kidney Int 2018; 93: 430–438.
  29. Goldstein FC, Levey AI, Steenland NK: High blood pressure and cognitive decline in mild cognitive impairment. J Am Geriatr Soc 2013; 61: 67–73.
  30. Smits CH, Deeg DJ, Kriegsman DM, Schmand B: Cognitive functioning and health as determinants of mortality in an older population. Am J Epidemiol 1999; 150: 978–986.
  31. Kurella M, Mapes DL, Port FK, Chertow GM: Correlates and outcomes of dementia among dialysis patients: the dialysis outcomes and practice patterns study. Nephrol Dial Transplant 2006; 21: 2543–2548.

Article / Publication Details

First-Page Preview
Abstract of Hemodialysis – Research Article

Received: August 13, 2018
Accepted: September 06, 2018
Published online: September 25, 2018
Issue release date: February 2019

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 4

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

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2019, Vol.47, No. 1-3

February 2019

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