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Abstract: TH-PO296

The Effect of Dialysis Modality Choice on Cognitive Functions in Patients with ESRD: A Meta-Analysis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Soliman, Karim Magdy Mohamed, Medical University of South Carolina , Charleston, United States
  • Ali, Hatem, Heartlands hospital, Birmingham, United Kingdom
  • Daoud, Ahmed, Cairo University, Cairo, Egypt
  • Mohamed, Mahmoud Magdy, Aghrass Medical center, Jeddah, Saudi Arabia
  • Fulop, Tibor, Medical University of South Carolina , Charleston, South Carolina, United States
  • Elsayed, Ingi, university hospitals of north midlands, Stoke-on-trent, United Kingdom
Background

Cognitive dysfunction is a major debilitating co-morbidity of end-stage renal disease, affecting up to 80% of the dialysis population. However, differential effect of hemodialysis (HD) versus peritoneal dialysis (PD) on cognitive dysfunction remains debated.

Methods

We performed a systematic review in different databases including Pubmed, Medline, Embase and Cochrane to identify studies that assessed effect of different dialysis modalities on cognitive functions. Inclusion criteria for our meta-analysis were all studies that compared effect of PD to intermittent HD on cognitive function. Studies were included with reviewing the journal title, year of publication, name of the first author, country of study and the number of enrolees in the PD and HD arms and the methods of assessment of cognitive functions were reported. A fixed effects model was used for the meta-analysis. Publication bias was assessed using a Funnel plot and Galbreith plot analysis.

Results

Out of 200 abstracts reviewed, 11 papers as well as registry studies were identified for this meta-analysis with a total of 219,320 subjects included (Figure 1). Forest plot analysis for the rate of cognitive impairment in different dialysis modalities showed less cognitive impairment in PD population compared to HD patients (Relative Risk = 0.49, 95% Confidence Intervals: 0.46 - 0.52). There was no evidence of heterogeneity in the forest plot analysis (I2 = 0.00%, P = 0.58, Figure 2). Moreover, there was no evidence of publication bias among the studies included (Figure 3 and 4).

Conclusion

Patients on PD show less cognitive dysfunction compared to those on HD.