The Comparison Between High-flux Hemodialysis And Conventional Hemodialysis On Cognitive Impairment In Long-term

Objective: The prevalence of cognitive impairment in hemodialysis patients had been revealed by a growing number of studies, and the positive effects of high-flux hemodialysis on cognitive function protection compared to the conventional hemodialysis had also been proposed. However, the attentions were mainly focused on the short-term effects of hemodialysis on cognitive functions. In this experiment, we investigated the long-term effect of both high-flux and conventional hemodialysis on the cognitive impairment of the patients. In addition, the level of β2-microglubin of the patients were measured to study the correlation.Methods: 122 patients with chronic kidney disease that were receiving hemodialysis in the hospital of Second Hospital of Hebei Medical Universty were recruited for the experiments. 62 of the patients received conventional hemodialysis for 12 months while the other 60 of them experienced 12 months of high-flux dialysis. 24 hours after the last hemodialysis session, the patients returned to the hospital for a thorough health check, which ensured that the patients were able to complete the cognitive function tests. After a 15-min cognitive functional test, blood samples of the patients were obtained to examine the level of β2-microglubin Cognitive performance was measured with Chinese version of The Montreal Cognitive Assessment(Mo CA). Data collected from the patients were analysed with Microsoft Excel 2010 and IBM SPSS Statistics 20 for windows. The corresponding risk factors were investigated spontaneously.Results:1 Demographic data showed no significant difference in the general physical conditions of the patients between the conventional hemodialysis group and the high-flux hemodialysis group.2 Patients in the high-flux hemodialysis group exhibited lower level of cognitive impairment in the 24 hours-afterward Mo CA.3 Patients in the high-flux hemodialysis group and conventional dialysis group exhibited same level of cognitive impairment in the 12 month-afterward hemodialysis.the deteriorating rate in some indicators of the cognitive function is higher in high-flux dialysis group.4 The change of β2-microglubin may be associated with cognitive decline.Conclusions:In short-term the high-flux hemodialysis patients displayed better executive functions, visuospatial ability and short-term memory, the patients in both group exhibited the same level of cognitive impairment in long-term. Moreover, the high-flux hemodialysis patients exhibited higher deterioration rate in executive function, visuospatial ability and language ability compared to the conventional hemodialysis patients during the 12 months, and this might be driven by the accumulation of β2-microglubin.