BLOOD PRESSURE VARIABILITY DURING HAEMODIALYSIS SESSION IMPAIRED COGNITIVE AND MOTOR FUNCTIONS IN URAEMIC PATIENTS: PP.8.330

Abstract

Introduction: Change in cognitive and motor function is one of the well known consequence of the end stage renal disease (ESRD). Little is known about influence of blood pressure during haemodialysis (HD) session on cognitive and motor functions. The aim of the study was to determinate whether blood pressure during HD session may impair cognitive and motor functions in HD patients. Subjects: In study were included 42 participants (14 females, 28 males) aged 54,36 ± 11,20 years (range 34–80) on chronic HD regimen 6,14 ± 3,97 years. The mean HD dose calculated as Kt/V was 1,32 ± 0,24. The systolic and diastolic arterial pressure were measured on the beginning and at the end of observed HD session. The pulse pressure (PP) and mean arterial pressure (MAP) were calculated, and differences between PP and MAP on the beginning and at the end of the HD were calculated (delta PP and delta MAP). Cognitive and motor abilities were investigated using a test of convergent thinking (test 11) from the Complex Reactiometer Drenovac (CRD) system. Results of the cognitive and motor abilities were given as total time of test solving in seconds (TT). Cognitive and motor parameters were calculated one hour before and one hour after the same HD session. Results: The differences between groups of subjects with delta PP>=8 mmHg and delta PP < 8 mmHg were found in preHD 11TT (207,54 ± 66,61 vs. 175,99 ± 43,94; p = 0,049) and postHD 11TT (183,01 ± 69,96 vs. 147,40 ± 36,33; p = 0,032). The subjects with predialysis systolic pressure >140 mmHg have significant differences in preHD 11TT compared with subjects with predialysis systolic pressure <140 mmHg, (215,74 ± 61,09 vs. 178,16 ± 54,24; p = 0,024). There was significant correlation between preHD 11TT and delta PP (Spearman's rho = 0,276; p = 0,047). Conclusion: Significant influence of arterial pressure on cognitive and motor functions in HD population was demonstrated. The intradialytic HD instability with variation between pre- and post HD blood pressure values is important factor in cognitive and motor functions deterioration.