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Hemodynamics During Dialysis and Changes in Cognitive Performance. WMJ 2016 12;115(6):311-6 PMID: 29094868

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INTRODUCTION: Hemodialysis (HD) patients are at increased risk for cognitive impairment. Blood

pressure (BP) fluctuations during HD may affect cerebral perfusion and subsequently cognitive


OBJECTIVE: Examine and provide information on the relationship between intradialytic hemodynamics

and cognitive outcomes over a 1-year period.

METHODS: HD patients without diagnosed dementia who were 50 years old or older were given a

neurocognitive battery at baseline and at 1-year follow-up. Over the 1-year period, we collected

demographic and laboratory data, as well as dialytic BP and ultrafiltration rate (UFR) measurements

and tested the association between changes in cognitive test scores and intradialytic

hemodynamics, adjusting for demographic and clinical variables.

RESULTS: Thirty-nine participants enrolled in the study and 32 remained at 1-year follow-up. The

mean (SD) age was 66.8 (10.0) years. Hypertension was present in 100% and diabetes mellitus

in 47% of the cohort. The average change in systolic BP from predialysis to postdialysis was -9.9

(16.3) mmHg, and average maximum drop in systolic BP during dialysis was 27.9 (10.2) mmHg.

Overall, the cognitive test scores did not have significant changes from baseline to 1 year. In

our linear regression analysis there was no association between the BP measures and cognitive

changes, although UFR was associated with change in performance on a test of executive functioning.

CONCLUSIONS: In prevalent HD patients, cognitive function was generally stable over a 1-year

period, and there was no association with intradialytic hemodynamic variables.

Author List

Wolfgram D, Vogt E, Jahn AL, Smith HM, Sussman J, Visotcky A, Laud P, Whittle J


Allison L. Jahn PhD Assistant Professor in the Psychiatry department at Medical College of Wisconsin
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


2-s2.0-85009110690   1 Citations

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

Cognitive Dysfunction
Kidney Failure, Chronic
Middle Aged
Neuropsychological Tests
Renal Dialysis
Risk Factors
jenkins-FCD Prod-321 98992d628744e349846c2f62ac68f241d7e1ea70