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Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
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Cognitive development continues throughout adulthood, undergoing significant shifts across early, middle, and late stages. Individual transition occurs from adolescent idealism to pragmatic and adaptable thinking in early adulthood. During this period, individuals learn to integrate personal beliefs with the recognition that other perspectives are equally valid. Exposure to the complexities of modern society, diverse experiences, and higher education contribute to this adaptive thought process,...
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Combining hemodialysis with peritoneal dialysis improves cognitive function: a three-case report.

Tomomi Maruki1, Takashin Nakayama1, Kohkichi Morimoto2

  • 1Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.

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Summary

Switching from peritoneal dialysis (PD) to hemodialysis (HD) may improve cognitive function in chronic kidney disease (CKD) patients. This suggests hemoglobin and albumin levels play key roles in dialysis-related cognitive decline.

Keywords:
Chronic kidney diseaseCognitive impairmentDementiaEnd-stage renal disease

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Area of Science:

  • Nephrology
  • Neurology
  • Geriatrics

Background:

  • Chronic kidney disease (CKD) is linked to cognitive impairment, a growing concern with aging populations.
  • Prolonged dialysis, including hemodialysis (HD) and peritoneal dialysis (PD), is associated with cognitive decline.

Observation:

  • Three patients on PD with cognitive impairment showed improved cognitive function after initiating HD.
  • Cognitive decline affected executive function and attention, assessed by the Montreal Cognitive Assessment (MoCA-J).
  • Patients reported subjective symptom improvement alongside objective cognitive gains.

Findings:

  • Initiating HD led to marked improvements in MoCA-J scores across multiple domains for all patients.
  • Improvements in anemia and hypoalbuminemia were noted in all three patients post-HD initiation.
  • No consistent trends were observed in other laboratory or physical examination parameters.

Implications:

  • Integrating HD into PD regimens may enhance cognitive function in CKD patients.
  • Hemoglobin and albumin levels may be critical factors in CKD-associated cognitive impairment.
  • This suggests a potential therapeutic strategy for managing cognitive decline in dialysis patients.