Aggravated cognitive impairment in maintenance hemodialysis patients——3 cases report

Objective To report three cases of aggravated cognitive impairment during hemodialysis and to explore the potential causes and treatments.Methods There were 3 patients, include 2 males and 1 female, developed cognitive impairment during dialysis. They all aged 72~82 years with dialysis duration of 1~14 years. And other 44 patients with age over 70 years without cognitive dysfunction served as control group include 21 males and 23 females, mean age (76.6+5.1) years old, the average duration of dialysis (86.3+68.2) months. Dialysis prescriptions, parameters, and biochemical results of the three patients and the control group were collected. We then compared the characteristics of the 3 patients at stable stage, symptomatic stage and stage after treatment. We also compared the 3 cases with the control group.Results There was no significant difference between the 3 cases and control group in dialysis time, blood flow velocity, URR, spKT/V, serum sodium concentration and osmotic pressure before and after dialysis (P>0.05).Conclusions The occurrence of cognitive dysfunction during dialysis in the 3 cases may be associated with decreased tolerance to the osmotic pressure change, elder age, essential brain injury, and complications. The symptoms can be alleviated by a mild dialysis prescription.