Abstract: FR-PO1042
Association of Cognitive Impairment with Common Hemodialysis-Related Outcomes
Session Information
- Hemodialysis: Clinical Challenges, Patient-Centered Outcomes, and Quality of Life
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Srivastava, Aman, Tufts University School of Medicine, Boston, Massachusetts, United States
- Drew, David A., Tufts University School of Medicine, Boston, Massachusetts, United States
- Trad, Omar K., Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
Background
End Stage Kidney Disease (ESKD) is associated with a high risk for cognitive impairment, which affects up to a third of patients. Identifying cognitive impairment may improve outcomes in hemodialysis (HD) given the complexity of ESKD treatment plans.
Methods
This single-center pilot study screened adult ESKD patients on maintenance HD using the Montreal Cognitive Assessment (MoCA) and evaluated associations with dialysis-related outcomes. Dialysis measures, assessed over three months post cognitive testing, were serum potassium, phosphorus and inter-dialytic weight gain. Additional outcomes ascertained one year following testing included dialysis attendance, hospitalization, transplantation, and mortality. Regression analyses evaluated relationships between cognition, dialysis metrics, and clinical outcomes.
Results
Of 46 screened, 25 were eligible and provided consent. The median MoCA score was 24. Subjects with MoCA score <24 were older (64 vs 56), had lower education, higher potassium (5.4 vs 5.1), higher hospitalization rates (15.2 vs 9.2 per 1000 person-days), and mortality rates (1.3 vs 0.2 per 1000 person-days). Higher MoCA scores were associated with lower serum potassium (β =-0.08; p=0.04) when adjusted for age. No significant relationships were seen with weight gain (β=-0.11; p=0.06) or serum phosphorus (β=-0.05; p=0.7). Higher MoCA scores were associated with a lower risk for hospitalization (Incident Rate Ratio (RR) [95% CI]=0.94; [0.89-0.99]; p=0.01) and mortality (RR=0.75; [0.62-0.92]; p=0.006). Both associations remained significant after age adjustment (hospitalization RR=0.90, [0.85-0.95]; mortality RR=0.72, [0.6-0.86]; both p<0.001).
Conclusion
Over half of the subjects had cognitive impairment (MoCA ≤ 25). Higher MoCA scores were associated with lower potassium concentrations, and lower risk for hospitalization and mortality. Our findings suggest future larger studies of cognitive screening in dialysis units should prioritize patient-centered rather than biochemical outcomes.