What does this research mean for the field?

Q: What does this research mean for the field?

Cognitive impairment is highly prevalent among chronic haemodialysis patients and is significantly correlated with alterations in cerebral and carotid haemodynamics. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

July 10, 2025Journal of Clinical MedicineOpen Access

Cerebral Haemodynamics and Cognitive Impairment in Chronic Haemodialysis Patients: A Pilot Study

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Why the study?

Patients with CKD on haemodialysis have elevated risks of cognitive impairment and cerebrovascular disease, but the relationship between cognitive performance and cerebral and carotid haemodynamics requires investigation.

Are cerebral and carotid haemodynamic alterations associated with cognitive impairment in chronic haemodialysis patients?

Structured PICO

Are cerebral and carotid haemodynamic alterations associated with cognitive impairment in chronic haemodialysis patients?

Population

32 patients (age 65 ± 12 years) undergoing chronic haemodialysis (HD) treatment

Outcome

Relationship between cognitive performance and cerebral and carotid haemodynamic indicessurrogate

In chronic haemodialysis patients, cognitive impairment is highly prevalent and significantly correlates with altered cerebral and carotid haemodynamics.

Implication

Altered haemodynamics may flag cognitive risk in dialysis; hypothesis-generating and requires prospective validation.

Abstract

Background: Patients with chronic kidney disease (CKD) have a substantially higher risk of developing cognitive impairment (CI) than the general population. Patients with CKD undergoing haemodialysis (HD) treatment also have an elevated risk of developing cerebrovascular and cardiovascular diseases. This study aims to investigate the relationship between the cognitive performance of haemodialysis patients and cerebral and carotid haemodynamic indices. Methods: This study was a non-interventional observational study; the sample consisted of 32 patients (age 65 ± 12 years) undergoing chronic HD treatment. The patients underwent neuropsychological and haemodynamic instrumental investigations, including Supra-Aortic Trunk Echodoppler (SAT) and Transcranial Doppler (TCD). Results: Patients were 17% deficient at Montreal Cognitive Assessment (MoCA), 45% deficient at Frontal Assessment Battery (FAB), 55% deficient at Trail-Making Test-A (TMT-A) and 65% deficient at TMT-B. The TCD investigation detected a decrease in flow (MFV) and an increase in Breath Hold Index (BHI) predominantly in the right cerebral arterial district. The SAT investigation revealed an altered IMT, plaques and the presence of severe carotid stenosis. A strong association between cerebral and carotid indices and cognitive scores was also observed. Correlation analyses reported statistically significant correlations between TMT-A and TMT-B and cerebral flow indices. Conclusions: Among haemodialysis patients, there is a high percentage of cognitive impairment associated and correlated with alterations in cerebral and carotid haemodynamics. Cerebral haemodynamics are a factor to be taken into consideration as a possible pathological mechanism underlying cognitive impairment in haemodialysis.