Pulse-wave velocity is associated with cognitive impairment in haemodialysis patients

Abstract

Chronic kidney disease (CKD) is common, its prevalence increasing with age. Cognitive impairment is common in the elderly, in CKD and in those on maintenance haemodialysis. As cognitive impairment is the precursor to dementia, the identification of reversible risk factors for cognitive decline is the key to reducing dementia risk. Arterial stiffness is one such potential risk factor. It is independently associated with cardiovascular outcome in dialysis patients. Importantly, the recent demonstration of an independent association between arterial stiffness and cognitive impairment in these patients suggests that vascular stiffness might be potentially causative in the development of cognitive impairment and also be an opportune target for interventions. Whether unstiffening of blood vessels in patients on maintenance haemodialysis can reduce the incidence of cognitive impairment or indeed slow its progression to dementia, remain unanswered questions. In this issue of the Clinical Science, present thought-provoking data related to cognitive impairment in haemodialysis patients.

Hemodialysis parameters and pulse wave velocity

“…[ 16 ] PWV is independently related to cardiovascular outcomes in dialysis patients. [ 18 ] It should also be emphasized that it predicts adverse cardiovascular outcomes in the general population and patients with CVD s.[ 19 ] In patients who receive HD regularly, diastolic dysfunction is an independent predictor of mortality and hospitalization. [ 20 ] Increased arterial stiffness has been linked to diastolic dysfunction in the left ventricle (LVDD); therefore, echocardiographic estimation of PWV is a sensitive and reliable method for verifying LVDD, and it carries favorable prognostic implications in such patients.…”