Abstract
Background: Cognitive impairment (CI) and dementia are common in patients with end-stage renal disease (ESRD) undergoing hemodialysis. Their cause is multifactorial. Our study is first to compare the impact of hemodialysis (HD) and online hemodiafiltration (HDF) on patients’ cognitive outcomes.Methods: This was a cross sectional, multicenter cohort study. Adult ESRD patients aged >18 years on regular high flux HD or online HDF were recruited in the study. Clinical, laboratory, daily activities and cognitive functions assessment were assessed in all the involved individuals.Results: A total of 241 patients were successfully recruited into the study: 164 treated with high flux HD and 77 treated with HDF. Hypertension and diabetes were the commonest associated comorbidities. 85.9% of patients were functionally independent with no significant difference between those on HD versus HDF. 81.3% of our patients showed different degrees of CI. HDF has no superiority in the improvement of cognitive functions. Age, vitamin D level and haemoglobin (Hb) were the most independent predictors of cognitive function impairment among HD patients.Conclusions: Cognitive function impairment is a common problem in hemodialysis and is associated with multiple risk factors. HDF showed no beneficial effect over HD. There is no superiority of online HDF versus high flux HD in improving cognitive functions.
Highlights
The mental process of acquiring knowledge using reasoning, perception and underlies all daily activities is known as cognition [1]
Cognitive function impairment is a common problem in hemodialysis and is associated with multiple risk factors
There is no superiority of online HDF versus high flux HD in improving cognitive functions
Summary
The mental process of acquiring knowledge using reasoning, perception and underlies all daily activities is known as cognition [1]. Cognitive impairment (CI) and dementia are common findings in end-stage renal disease (ESRD) and hemodialysis patients [2]. Cognitive function impairment negatively affects functional dependence and behavioral symptoms, leading to poor outcomes and decreased compliance with medications and medical care [5,6]. The prevalence of cognitive function impairment among ESRD patients varies from 16 to 38% [7]. Many tools have been used to assess cognitive functions in HD patients. The Mini-Mental State Examination (MMSE) is the most frequently used worldwide, but the Montreal Cognitive Assessment (MOCA) was better in detecting mild CI. Cognitive impairment (CI) and dementia are common in patients with end-stage renal disease (ESRD) undergoing hemodialysis. Our study is first to compare the impact of hemodialysis (HD) and online hemodiafiltration (HDF) on patients’ cognitive outcomes
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