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Haemodynamics during dialysis and cognitive performance. Nephrology (Carlton) 2014 Dec;19(12):771-6 PMID: 25103846 PMCID: PMC4452995

Pubmed ID

25103846

DOI

10.1111/nep.12324

Abstract

BACKGROUND AND AIMS: Persons receiving haemodialysis (HD) are at increased risk of cognitive impairment (CI). Since blood pressure (BP) fluctuations during HD may affect cerebral perfusion - and subsequently cognitive function - we examined the relationship between dialytic BP fluctuation and cognitive outcomes.

METHODS: We included HD patients without diagnosed dementia who were 50 years or older. Using established methods, we classified participants' in CI categories (none to mild and moderate to severe) based on results of a neurocognitive battery. We collected demographic and laboratory data from dialysis unit records, as well as all BP measurements from 12 dialysis sessions. We tested the association between CI and BP fluctuation, adjusting for demographic and laboratory variables.

RESULTS: Our study enrolled 39 patients; 25 had moderate to severe CI. The normal to mild CI group and the moderate to severe patients had similar degrees of BP fluctuation (average minimum systolic BP (SBP): 107.6 ± 18.7 vs 110.2 ± 18.6 mmHg, maximum drop in SBP: 32.6 ± 10.2 vs 35.4 ± 15.0 mmHg; proportion of sessions with SBP < 90 mmHg: 0.2 ± 0.3 vs 0.2 ± 0.3; average change in SBP, pre to post HD: 10.2 ± 12.4 vs 11.8 ± 16.4 mmHg, all P > 0.55). There was no association between BP variables and performance on individual cognitive tests. Multivariable analysis showed that older age and non-Caucasian race were associated with a reduction in cognitive scores.

CONCLUSIONS: There was no cross-sectional association between dialytic BP changes and cognitive performance.

Author List

Wolfgram DF, Sunio L, Vogt E, Smith HM, Visotcky A, Laud P, Whittle J

Authors

Purushottam W. Laud PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Heather M. Smith PhD Associate Professor in the Psychiatry department at Medical College of Wisconsin
Jeffrey Whittle MD Professor in the Medicine department at Medical College of Wisconsin
Dawn Felicity Wolfgram MD Associate Professor in the Medicine department at Medical College of Wisconsin




Scopus

2-s2.0-84939437153   7 Citations

MESH terms used to index this publication - Major topics in bold

Age Factors
Aged
Blood Pressure
Cerebrovascular Circulation
Cognition
Cognition Disorders
Cross-Sectional Studies
Hemodynamics
Humans
Kidney Failure, Chronic
Linear Models
Logistic Models
Middle Aged
Multivariate Analysis
Neuropsychological Tests
Renal Dialysis
Risk Factors
Severity of Illness Index
Wisconsin
jenkins-FCD Prod-321 98992d628744e349846c2f62ac68f241d7e1ea70