Table 1.
Patient characteristics
| Characteristic | Total, n=12 |
|---|---|
| Age | 75.4±5.2 |
| Men | 7 (58%) |
| BMI, kg/m2 | 26.6±3.5 |
| Primary kidney disease: | |
| GN | 4 (33%) |
| Diabetes | 1 (8%) |
| Vascular | 3 (25%) |
| Other diagnosis | 3 (25%) |
| Unknown | 1 (8%) |
| Dialysis vintage, mo | 46 (range 11–319) |
| Dialysis treatment time, h/wk | 12 (range 8–15) |
| Kt/V, per wk | 3.91±0.73 |
| % IDH-complicated HD sessions 30 d before study sessiona | |
| Never | 8 (67%) |
| In 10%–20% of HD sessions | 2 (17%) |
| In 30%–40% of HD sessions | 2 (17%) |
| Comorbidities | |
| Diabetes | 3 (25%) |
| Hypertension | 11 (73%) |
| Myocardial infarction | 2 (17%) |
| Heart failure | 1 (8%) |
| Peripheral artery disease | 1 (8%) |
| COPD | 1 (8%) |
| Depression | 1 (8%) |
| Medication | |
| CCB | 4 (33%) |
| Nitrate | 3 (25%) |
| ACE inhibitor | 1 (8%) |
| Angiotensin receptor blocker | 1 (8%) |
| B-blocker | 9 (75%) |
| Neuropsychologic assessment | |
| MMSEb | 28 (range 25–29) |
| RAVLT, delayed recallc | 6.8±3.4 |
| Digit span forwardc | 5.1±0.8 |
| Digit span backwardc | 3.8±1.1 |
| TMT-A, secc | 71.3±28.6 |
| TMT-B, secc | 200±94 |
| TMT B/A ratiod | 2.59±0.90 |
| Letter fluencyc | 24.6±12.1 |
| Clock drawing scorec | 14 (range 9–14) |
| HADS depression scoree | 6.0±3.9 |
| HADS anxiety score | 3.9±3.6 |
| MRI brain | |
| GCA score | |
| 0 – no atrophy | 1 (8%) |
| 1 – mild atrophy | 8 (67%) |
| 2 – moderate atrophy | 3 (25) |
| 3 – severe atrophy | 0 |
| Fazekas score of WML | |
| 0 – no WML | 1 (8%) |
| 1 – multiple punctate lesions | 4 (33%) |
| 2 – beginning confluent lesions | 5 (42%) |
| 3 – large confluent WML | 2 (17%) |
| Microbleeds | 7 (58%) |
Data are presented as mean±SD or median (range), or percentages (%). BMI, body mass index; IDH, intradialytic hypotension; COPD, chronic obstructive pulmonary disease; CCB, calcium channel blocker; ACE, angiotensin-converting enzyme; MMSE, Mini Mental State Examination; RAVLT, Rey Auditory Verbal Learning Test; TMT, trail making test; HADS, hospital anxiety depression scale; GCA, global cortical atrophy; WML, white matter lesions.
IDH was defined as an SBP drop <100 mm Hg, any IDH-related intervention during HD, or IDH symptoms including dizziness or loss of consciousness.
An MMSE score ≥24 indicates normal cognition.
The number of patients that were impaired according the age-, sex-, and education-adjusted norm scores were: 0 (RAVLT), 2 (total digit span score, only age-adjusted), 4 (TMT-A, TMT-B), 2 (letter fluency), and 1 (clock drawing).
Three patients had a TMT B/A ratio >3.0 indicating executive function impairment.
A score >7 on the HADS depression (n=3) or anxiety (n=1) indicates the presence of symptoms of depression or anxiety, respectively.