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Cognitive function in hemodialysis patients.

M Jackson, E K Warrington, C J Roe

    Clinical Nephrology
    |January 1, 1987
    PubMed
    Summary
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    Cognitive function in hemodialysis patients showed no significant differences based on water aluminum exposure. However, oral aluminum intake correlated with poorer cognitive performance in long-term patients, suggesting reduced prescription of aluminum binders.

    Area of Science:

    • Nephrology
    • Neuroscience
    • Environmental Health

    Background:

    • Hemodialysis patients are potentially exposed to aluminum from dialysate.
    • Aluminum exposure has been linked to neurological complications.

    Purpose of the Study:

    • To assess cognitive function in hemodialysis patients with low-level aluminum exposure from dialysate.
    • To investigate the relationship between aluminum exposure (water-borne and oral) and cognitive performance.

    Main Methods:

    • Cognitive function was evaluated in two groups: long-term (≥5 years) and short-term (<5 years) hemodialysis patients.
    • Patients were exposed to low aluminum concentrations in dialysate.
    • Cognitive deterioration was assessed using the Wechsler Adult Intelligence Scale and reading skills.

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  • Correlation analysis was performed between cumulative aluminum exposure and cognitive measures.

    • Main Results:

    • No significant cognitive differences were found between short-term and long-term hemodialysis groups.
    • A small number of patients in both groups showed cognitive deterioration below predicted levels.
    • No correlation was observed between dialysate aluminum exposure and cognitive function.
    • A significant negative correlation existed between cumulative oral aluminum intake and cognitive test performance in the long-term group.

    Conclusions:

    • Low-level aluminum exposure via dialysate does not appear to significantly impact cognitive function in hemodialysis patients.
    • Oral aluminum intake, particularly in long-term patients, is associated with impaired cognitive performance.
    • Minimizing the prescription of aluminum-containing phosphate binders is recommended for hemodialysis patients.