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Abstract: PO0802

Dialysis Adequacy and Risk of Dementia in Elderly Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kim, Hyung Woo, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
  • Jhee, Jong Hyun, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of)
  • Joo, Young Su, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of)
  • Yang, Ki Hwa, Health Insurance Review and Assessment Service, Wonju, Korea (the Republic of)
  • Jung, Jin Ju, Health Insurance Review and Assessment Service, Wonju, Korea (the Republic of)
  • Shin, Ji Hyeon, Health Insurance Review and Assessment Service, Wonju, Korea (the Republic of)
  • Han, Seung Hyeok, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
  • Yoo, Tae-Hyun, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
  • Kang, Shin-Wook, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
  • Park, Jung Tak, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
Background

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/1000 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.

Conclusion

Increased dialysis clearance was associated with a lower risk of developing dementia in elderly hemodialysis patients.