Anemia Tied to Cognitive Decline in Dialysis Patients

TOPLINE:

A substantial proportion of patients with end-stage renal disease undergoing regular hemodialysis showed cognitive impairment in this cross-sectional study, with higher hemoglobin levels associated with better cognitive function across various domains.

METHODOLOGY:

• Cognitive impairment is common among patients with end-stage renal disease requiring maintenance hemodialysis, with notable impacts on quality of life and treatment; however, the association between cognitive impairment and hemoglobin levels remains underexplored.
• Researchers conducted a cross-sectional study involving 248 patients with end-stage renal disease (mean age, 57.23 years; 49.6% men) undergoing maintenance hemodialysis for more than 6 months (three times weekly for 4 hours each) to investigate the association between hemoglobin levels and cognitive impairment.
• Hemoglobin levels along with other biochemical parameters, including albumin levels, were measured once during the study; hemoglobin levels were categorized into quartiles (Q1, < 90 g/L; Q2, 90-110 g/L; Q3, 110-130 g/L; and Q4, > 130 g/L).
• The cognitive function assessment utilized the Chinese-translated Mini-Mental State Examination test, with scores < 24 indicating cognitive impairment.

TAKEAWAY:

• Around one third of patients (33.90%) exhibited cognitive impairment, and the number of patients affected declined significantly from 37 in the lowest quartile of hemoglobin levels to eight in the highest quartile (P < .001).
• Multiple factors, including age (odds ratio [OR], 1.454; P < .001), male sex (OR, 0.171; P = .013), predialysis diastolic blood pressure (OR, 0.884; P = .024), uric acid levels (OR, 0.992; P = .007), and hemoglobin levels (OR, 0.899; P < .001), were significantly associated with cognitive function.
• Patients in the lowest quartile of hemoglobin levels faced a substantially higher risk for cognitive impairment than those with normal hemoglobin levels (Q1 vs Q3: OR, 15.395; P < .001).

IN PRACTICE:

“Adequate hemoglobin levels may not only improve physical health but also enhance cognitive function, which is crucial for the overall well-being of this patient population,” the authors wrote.

SOURCE:

This study was led by Lin Huang, Blood Purification Center, Affiliated Yijishan Hospital of Wannan Medical College in Wuhu, China. It was published online in BMC Nephrology.

LIMITATIONS:

The cross-sectional design of this study prevented establishing causal relationships between anemia and cognitive impairment. The relatively small sample size and single-center nature of the study may have introduced selection bias and limited generalizability. The use of Mini-Mental State Examination instead of Montreal Cognitive Assessment may have led to underestimation of cognitive impairment incidence.

DISCLOSURES:

This study was supported by the Three New Project of Affiliated Yijishan Hospital of Wannan Medical College and the Wannan Medical College Young and Middle-Aged Research Fund. The authors declared no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.