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Cognitive impairment in hemodialysis patients is common
Abstract
BACKGROUND: Hemodialysis patients are at high risk for cognitive impairment due to their older age and high prevalence of stroke and cardiovascular risk factors. METHODS: Using a cross-sectional design, the authors measured cognitive function in 374 hemodialysis patients aged 55 years and older and an age-matched comparison group in Minneapolis and St. Paul, MN. Cognitive performance was measured in three domains: memory, executive function, and language. Subjects were classified as having no, mild, moderate, or severe cognitive impairment. RESULTS: Of 338 subjects who completed testing in at least two of the three cognitive domains, 13.9% (95% CI 10.4, 18.1) were classified with mild impairment, 36.1% (31.0, 41.5) with moderate impairment, 37.3% (32.1, 42.7) with severe impairment, and 12.7% (9.4, 16.8) with normal cognition. Only 2.9% had a documented history of cognitive impairment. Factors associated with severe cognitive impairment on adjusted logistic regression were stroke (adjusted OR [AOR] 1.95; 95% CI 1.08, 3.49; p < 0.03), equilibrated Kt/V > 1.2 (1.67; 1.01, 2.75; p < 0.05), and education >12 years (0.32; 0.14, 0.72; p < 0.01). The AOR for severe cognitive impairment in a random sample of 101 hemodialysis patients vs an age-matched comparison group was 3.54 (1.28, 9.78; p < 0.02). CONCLUSIONS: Moderate to severe cognitive impairment is common and undiagnosed in hemodialysis patients. Further studies are needed to determine whether dialysis exacerbates the cognitive impairment attributable to underlying disease. Cognitive testing in hemodialysis patients before dialysis initiation and periodically may be warranted.
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“Half of all hemodialysis patients report pain symptoms, which are often inadequately controlled with medication [15,16].”
From Should there be an expanded role for palliative care in end-stage renal disease? (2010) · cites this paper as [16]
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“Cognitive impairment (CI) is common in individuals with chronic kidney disease (CKD), especially in hemodialysis patients with end-stage renal disease (ESRD) (Murray et al., 2006).”
From Association Between Sleep Disorders and Cognitive Impairment in Middle Age and Older Adult Hemodialysis Patients: A Cross-Sectional Study (2021) · cites this paper as Murray et al., 2006
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Foote, C., Woodward, M., & Jardine, M. (2017) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2017.02.005 · Cited by 11
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Metadata
- Authors
- Murray, A. M., Tupper, D. E., Knopman, D. S., Gilbertson, D. T., Pederson, S. L., Li, S., Smith, G. E., Hochhalter, A. K., Collins, A. J., & Kane, R. L.
- Affiliations
- University of Minnesota (US)
- Venue
- Neurology
- Published
- 2006-07-25
- Volume
- 67
- Issue
- 2
- Pages
- 216-223
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2077510921
- Cited by
- 712
- References
- 48
- Citations by year
- 2026: 26 · 2025: 31 · 2024: 50 · 2023: 44 · 2022: 42 · 2021: 41 · 2020: 55 · 2019: 46 · 2018: 41 · 2017: 38 · 2016: 32 · 2015: 34 · 2014: 39 · 2013: 44 · 2012: 28
- FWCI
- 12.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (K021174A)
- National Center for Research Resources (M01RR000400)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Medicine › Oncology › Cancer-related cognitive impairment studies
- Keywords
- cognitive impairment, hemodialysis, end-stage renal disease, memory, executive function, language, stroke, older adults, cognitive screening
- MeSH terms
- Aged, Aged, 80 and over, Cognition Disorders, Cross-Sectional Studies, Female, Renal Dialysis, Humans, Kidney Failure, Chronic, Male, Middle Aged, Minnesota, Risk Factors, Cohort Studies, Comorbidity, Prevalence, Age Distribution, Sex Distribution, Risk Assessment
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