Journal of Clinical & Experimental Nephrology

The Impact of Inflammation and Autonomic Nervous System Activity on Cognitive Impairment during a Hemodialysis Session

Background: Cognitive dysfunction is a common abnormality found in Chronic Kidney Disease (CKD) patients and especially during hemodialysis (HD) treatment. It is supported that inflammation and Autonomic Nervous System (ANS) dysfunction are implicated in cognitive impairment. The aim of this study was to determine the relationship between inflammation, ANS activity and cognitive function during a HD session. Methods: 15 HD patients gave informed consent to participate in this study. Autonomic Nervous System activity was evaluated by the method of pupillometry, cognitive function with the Mini Mental State Examination (MMSE) questionnaire, and inflammation with the biomarker of C-Reactive Protein (CRP) before and after a dialysis session. Results: After the HD session, from the pupillometric indices only Average Dilation Velocity decreased by 5.2% (p<0.05) and MMSE score decreased by 14.3% (p<0.05). After the HD session CRP levels significantly increased by 39.6% (p<0.05). Before HD therapy MMSE score was significantly correlated with years in HD therapy (r=-0.663, p=0.014), Maximum Constriction Velocity (r=-0.744, p=0.001) and CRP levels (r=-0.621, p=0.013). Similarly, after the completion of the HD therapy MMSE was correlated with years in HD therapy (r=-0.767, p=0.002), Maximum Constriction Velocity (r=-0.597, p=0.019) and CRP levels (r=-0.513, p=0.05). Conclusion: The results of the present study suggest that inflammation and ANS function, which are deteriorated after the dialysis session, seem to contribute to cognitive impairment in HD patients.

Author(s):

Antonia Kaltsatou1, Evangelia Kouidi, Vassilios K. Kimiskidis, Vassilios Liakopoulos,Vassiliki Michou, Themis Christofi, Asterios Deligiannis

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