Impact of hemodialysis on cognition

Abstract

Background: Cognitive impairment is a significant yet underrecognized complication among patients undergoing hemodialysis. Studies indicate that up to 30% of hemodialysis patients develop dementia, with many experiencing mild cognitive impairment (MCI) as a precursor. The progression of chronic kidney disease (CKD) to end-stage renal disease (ESRD) requiring hemodialysis is associated with worsening cognitive function, potentially due to factors such as uremic toxin accumulation, haemodynamic instability, and inflammation.

Aimed to assess the presence and extent of cognitive impairment in patients with CKD undergoing haemodialysis and to identify contributing factors.

Material & Method: This cross-sectional study was conducted at BLDE (DU), Shri B.M. Patil Medical College Hospital and Research Centre, Vijayapura, over 18 months (May 2023 – December 2024). A total of 64 patients undergoing maintenance hemodialysis were assessed for cognitive impairment using the Montreal Cognitive Assessment (MoCA). Data were analyzed using SPSS Version 20, with independent t-tests and Chi-square tests applied for statistical significance (p<0.05).

Results: The mean age of participants was 52.67±14.2 years, with 62.5% males and 37.5% females. Hypertension (50%) and diabetes (31.3%) were common comorbidities. Cognitive impairment was present in 40.6% of patients. Patients with cognitive impairment had significantly longer CKD duration (2.5 years vs. 1.6 years) and haemodialysis duration (8.6 months vs. 3.5 months) (p<0.05).

Conclusion: Cognitive impairment is prevalent in hemodialysis patients and is associated with longer CKD and dialysis durations. Early screening and intervention strategies are essential to mitigate cognitive decline and improve patient outcomes.