Cognitive Impairment is Commonplace in Hemodialysis Patients

Minneapolis, 25 July 2006 - A study conducted by Dr. Anne Murray at the Minneapolis Medical Research Foundation and David Knopman, a neurologist at the Mayo Clinic, has found that mild to severe cognitive impairment is commonplace and often goes undiagnosed among patients undergoing hemodialysis.  The study, published in Neurology on July 25th, found that 87.3% of 338 hemodialysis patients suffered from some level of cognitive impairment.  About 37% had severe cognitive impairment, at the level of dementia.  Only 2.9% of these patients had a documented history of cognitive impairment before undergoing treatment.

“This study is the first to examine the issue of cognitive impairment in a large number of hemodialysis patients.” said Dr. Murray, staff geriatrician and epidemiologist at Hennepin County Medical Center, and Assistant Professor of Medicine.  “This study shows that cognitive impairment is going undetected and undiagnosed in these patients. It also suggests that we need to reexamine the way dialysis is administered; perhaps slower, gentler dialysis, such as peritoneal and home dialysis would be easier on the brain.  Based on her research, Dr. Murray also recommends that all hemodialysis patients undergo a cognitive assessment before undergoing treatment and receive annual assessments thereafter. “We don’t know whether patients with severe chronic kidney disease (prior to starting dialysis) have adequate judgment to make the decision to start dialysis. It is also unclear whether dialysis patients are able to comply with complex medication regimens, or make an informed decision to stop dialysis when appropriate.”

Hemodialysis patients are at higher risk for cognitive impairment due to a number of factors including older age, cardiovascular risk factors, and metabolic disturbances.

The study group consisted of 338 individuals aged 55 years and older, residing in Minneapolis and St. Paul Minn.  Cognitive performance was measured in three domains, memory, executive function, and language.  The results were compared to an age-matched comparison group.

The MMRF oversees the research on the campus of Hennepin County Medical Center (HCMC), a nationally recognized research and teaching hospital. The mission of the MMRF is to improve patient care and the health of our community through research and education. The MMRF is the third largest non-profit medical research organization in Minnesota and it ranks in the top 10% of all institutions receiving research funding from the NIH.

###