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

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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.

Original languageEnglish
Article number769490
JournalFrontiers in Medicine
Publication statusPublished - 2021 Nov 30

Bibliographical note

Funding Information:
This research was supported by a grant from the Joint Project on Quality Assessment Research, Republic of Korea. The epidemiologic data used in this study were obtained from Periodic Hemodialysis Quality Assessment by HIRA.

Publisher Copyright:
Copyright © 2021 Kim, Jhee, Joo, Yang, Jung, Shin, Han, Yoo, Kang and Park.

All Science Journal Classification (ASJC) codes

  • Medicine(all)


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