Work

Longitudinal assessment of cognitive decline in hemodialysis patients: unveiling sex disparities

Year: 2026

Type: article

Abstract: ABSTRACT Background Numerous studies have delved into the prevalence, risk factors, and outcomes associated with cognitive impairment in hemodialysis patients. However, a scarcity of data exists regarding the trajectory of cognitive decline and potential contributing factors. Methods We recruited 247 prevalent hemodialysis patients for this study. Baseline and follow-up cognitive assessments were conducted in 90 patients using the Montreal Cognitive Assessment (MoCA) at a 2-year interval. To identify potential predictors of cognitive decline, we analyzed traditional risk factors alongside dialysis-related variables. Additionally, surrogate parameters of vascular calcification and arterial stiffness, such as T50 values and pulse wave velocity, were investigated. Results After a 2-year follow-up period (24.3 ± 1.05 months), MoCA test results revealed a significant decline in cognitive function (−1.8 ± 3.2 points, P < 0.001). Overall, 37 patients (41%) exhibited cognitive decline, defined as a decrease in MoCA score of >2 points, indicating disease progression. The median change in MoCA score differed significantly between males (−3.0, range 0.0 to −5 points) and females (0.0, range 1.0 to −1.75 points, P = 0.002). This finding was corroborated by multivariable analyses adjusted for age, educational level, diabetes and blood pressure measurements (regression coefficient −2.5, P = 0.006). The association was further confirmed in a comparison between patients with stable and declining cognitive function (regression coefficient 2.65, odds ratio 14.2, P = 0.007). None of the other variables reached statistical significance. Conclusions Our findings underscore a substantial deterioration in cognitive function over time among hemodialysis patients. Notably, our data reveal a more rapid decline in cognitive function among males, shedding light on previously unrecognized sex differences in this patient population.

Source: Clinical Kidney Journal

DOI: 10.1093/ckj/sfag340