Dialysis Adequacy and Risk of Dementia in Elderly Hemodialysis Patients

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 hemod...

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Autores principales:	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
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	hemodialysis adequacy dementia hemodialysis Alzheimer's disease vascular dementia Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/7dbe0d3c26794bf2a4142acce5f0ac1b
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spelling	oai:doaj.org-article:7dbe0d3c26794bf2a4142acce5f0ac1b2021-12-01T15:25:29ZDialysis Adequacy and Risk of Dementia in Elderly Hemodialysis Patients2296-858X10.3389/fmed.2021.769490https://doaj.org/article/7dbe0d3c26794bf2a4142acce5f0ac1b2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.769490/fullhttps://doaj.org/toc/2296-858XObjective: 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.Hyung Woo KimJong Hyun JheeYoung Su JooYoung Su JooKi Hwa YangJin Ju JungJi Hyeon ShinSeung Hyeok HanTae-Hyun YooShin-Wook KangShin-Wook KangJung Tak ParkFrontiers Media S.A.articlehemodialysis adequacydementiahemodialysisAlzheimer's diseasevascular dementiaMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	hemodialysis adequacy dementia hemodialysis Alzheimer's disease vascular dementia Medicine (General) R5-920
spellingShingle	hemodialysis adequacy dementia hemodialysis Alzheimer's disease vascular dementia Medicine (General) R5-920 Hyung Woo Kim Jong Hyun Jhee Young Su Joo Young Su Joo Ki Hwa Yang Jin Ju Jung Ji Hyeon Shin Seung Hyeok Han Tae-Hyun Yoo Shin-Wook Kang Shin-Wook Kang Jung Tak Park Dialysis Adequacy and Risk of Dementia in Elderly Hemodialysis Patients
description	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.
format	article
author	Hyung Woo Kim Jong Hyun Jhee Young Su Joo Young Su Joo Ki Hwa Yang Jin Ju Jung Ji Hyeon Shin Seung Hyeok Han Tae-Hyun Yoo Shin-Wook Kang Shin-Wook Kang Jung Tak Park
author_facet	Hyung Woo Kim Jong Hyun Jhee Young Su Joo Young Su Joo Ki Hwa Yang Jin Ju Jung Ji Hyeon Shin Seung Hyeok Han Tae-Hyun Yoo Shin-Wook Kang Shin-Wook Kang Jung Tak Park
author_sort	Hyung Woo Kim
title	Dialysis Adequacy and Risk of Dementia in Elderly Hemodialysis Patients
title_short	Dialysis Adequacy and Risk of Dementia in Elderly Hemodialysis Patients
title_full	Dialysis Adequacy and Risk of Dementia in Elderly Hemodialysis Patients
title_fullStr	Dialysis Adequacy and Risk of Dementia in Elderly Hemodialysis Patients
title_full_unstemmed	Dialysis Adequacy and Risk of Dementia in Elderly Hemodialysis Patients
title_sort	dialysis adequacy and risk of dementia in elderly hemodialysis patients
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/7dbe0d3c26794bf2a4142acce5f0ac1b
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Dialysis Adequacy and Risk of Dementia in Elderly Hemodialysis Patients

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