End stage renal disease is associated with development of dementia

// Peir-Haur Hung 1, 2 , Chih-Ching Yeh 3, 4 , Chih-Yen Hsiao 1, 5 , Pi-Shan Sung 6, 7 , Chih-Hsin Muo 8 , Fung-Chang Sung 8, 9 , Kuan-Yu Hung 10 and Kuen-Jer Tsai 6, 11 1 Department of Internal Medicine, Ditmanson Medical Foundation Chia-yi Christian Hospital, Chia-yi, Taiwan 2 Department of Applied Life Science and Health, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan 3 School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan 4 Department of Public Health, China Medical University, Taichung, Taiwan 5 Department of Hospital and Health Care Administration, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan 6 Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan 7 Department of Neurology, National Cheng Kung University Hospital, Tainan, Taiwan 8 Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan 9 Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan 10 Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu City, Taiwan 11 Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Correspondence to: Kuen-Jer Tsai, email: kjtsai@mail.ncku.edu.tw Keywords: Alzheimer’s disease, end stage renal disease, hemodialysis, peritoneal dialysis, dementia, Gerotarget Received: March 29, 2017      Accepted: October 12, 2017      Published: November 15, 2017 ABSTRACT There is controversy regarding the extent of risk for dementia in patients with end stage renal disease (ESRD) who are undergoing hemodialysis (HD) or peritoneal dialysis (PD). We examined data from Taiwan’s Longitudinal Health Insurance Database, and used Cox proportional hazard regression analysis to compare the development of dementia in 72,934 HD and PD patients with 72,934 matched controls from January 1, 1999 to December 31, 2010. The results indicate an increased risk for dementia overall in HD patients (adjusted hazard ratio [aHR] = 1.64, p < 0.0001) and PD patients (aHR = 2.21, p < 0.0001). HD and PD patients also had significantly greater aHRs for vascular dementia (VaD) and unspecified dementia (UnD), but only HD patients had a significantly greater aHR for Alzheimer’s disease (AD). Further research is needed to confirm whether management of ESRD with PD can reduce the incidence of AD, and to identify the mechanisms by which ESRD increases the risk of dementia.