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Dialysis Adequacy and Risk of Dementia in Elderly Hemodialysis Patients

 Hyung Woo Kim  ;  Jong Hyun Jhee  ;  Young Su Joo  ;  Ki Hwa Yang  ;  Jin Ju Jung  ;  Ji Hyeon Shin  ;  Seung Hyeok Han  ;  Tae-Hyun Yoo  ;  Shin-Wook Kang  ;  Jung Tak Park 
 FRONTIERS IN MEDICINE, Vol.8 : 769490, 2021-11 
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Objective: Dementia is prevalent among elderly patients undergoing hemodialysis. However, the association between dialysis adequacy and the risk of dementia is uncertain.

Methods: A total of 10,567 patients aged >65 years undergoing maintenance hemodialysis who participated in a national hemodialysis quality assessment program were analyzed. The patients were classified into quartile groups based on single-pool Kt/V levels. The associations between single-pool Kt/V and the development of dementia, Alzheimer's disease (AD), and vascular dementia (VD) were examined.

Results: The mean age of the patients was 72.9 years, and 43.4% were female. The mean baseline single-pool Kt/V level was 1.6 ± 0.3. During a median follow-up of 45.6 (45.6–69.9) months, there were 27.6, 23.9, and 2.8 events/1,000 person-years of overall dementia, AD, and VD, respectively. The incidences of overall dementia, AD, and VD were lowest in the highest single-pool Kt/V quartile group. Compared with the lowest single-pool Kt/V quartile, the risks of incident overall dementia and AD were significantly lower in the highest quartile [sub-distribution hazard ratio (sHR): 0.69, 95% confidence interval (CI): 0.58–0.82 for overall dementia; sHR: 0.69, 95% CI: 0.57–0.84 for AD]. Inverse relationships were found between the risks of developing overall dementia and AD, and single-pool Kt/V. However, no significant relationship was observed between single-pool Kt/V levels and VD development.

Conclusions: Increased dialysis clearance was associated with a lower risk of developing dementia in elderly hemodialysis patients.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Kim, Hyung Woo(김형우) ORCID logo https://orcid.org/0000-0002-6305-452X
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Joo, Young Su(주영수) ORCID logo https://orcid.org/0000-0002-7890-0928
Jhee, Jong Hyun(지종현)
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
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