Dialysis and cognitive impairment

Area of Science:

• Nephrology
• Neurology
• Cognitive Science

Background:

• Chronic kidney disease (CKD) patients on maintenance dialysis exhibit faster cognitive decline than those with advanced kidney disease not on dialysis.
• This cognitive impairment is significant for patients, caregivers, and healthcare systems but often underestimated.
• Comorbidities in CKD patients can affect brain health, but dialysis itself is increasingly implicated in cognitive decline.

Purpose of the Study:

• To explore the mechanisms underlying dialysis-induced cognitive decline in CKD patients.
• To review established and potential pathophysiological pathways linking dialysis to brain changes.
• To consider therapeutic interventions for mitigating cognitive impairment in this population.

Main Methods:

• Review of existing literature on dialysis and cognitive function in CKD.
• Analysis of evidence implicating dialysis therapy in brain structure and function changes.
• Exploration of potential therapeutic strategies, both single and complex.

Main Results:

• Both hemodialysis and peritoneal dialysis are associated with structural and functional brain alterations.
• Dialysis can lead to short-term neurological symptoms like confusion and brain fog.
• Long-term effects include progressive reductions in cognitive functional ability.

Conclusions:

• Dialysis therapy plays a central role in the pathophysiology of progressive cognitive impairment in CKD patients.
• Understanding these mechanisms is crucial for developing effective interventions.
• Further research and therapeutic approaches are needed to address dialysis-related cognitive decline.