Evidence map›Paper›PMID 25742686›Full record

ArticlePeritoneal dialysis international : journal of the International Society for Peritoneal Dialysis

Risk of dementia in peritoneal dialysis patients compared with hemodialysis patients.

Dawn F Wolfgram, Aniko Szabo, Anne M Murray, Jeff Whittle

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
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  6. Review
  7. Article
  8. Article
  9. Article
  10. Review
  11. Article
  12. Review
  13. Dialysis and cognitive impairment.Nature reviews. Nephrology · 2025
    Review
  14. Care pathways for patients with cognitive impairment and chronic kidney disease.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025
    Review
  15. Review
  16. Article
  17. Observational
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  19. Article
  20. More rapid progression of brain atrophy in patients on peritoneal dialysis compared with hemodialysis: The VCOHP Study.Hypertension research : official journal of the Japanese Society of Hypertension · 2024
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Dawn F WolfgramDivision of Nephrology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI Section of Nephrology, Department of Medicine, Zablocki VA Medical Center, Milwaukee, WI.
Aniko SzaboDivision of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI.
Anne M MurrayDivision of Geriatrics, Department of Medicine, Hennepin County Medical Center and University of Minnesota, Minneapolis, MN.
Jeff WhittleDivision of General Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI Primary Care, Department of Medicine, Zablocki VA Medical Center, Milwaukee, WI.

Funding

Clincal and Translational Science AwardUL1TR000055 · NCATS · MEDICAL COLLEGE OF WISCONSIN · PI SHAKER, REZA NONE · 2012 to 2015
$11.3M
NCATS NIH HHS 8UL1TR000055NCATS NIH HHS UL1 TR000055
6 · The paper itself

Abstract

backgroundCompared with similarly aged controls, patients with end-stage renal disease (ESRD) have a higher prevalence of cognitive impairment and more rapid cognitive decline, which is not explained by traditional risk factors alone. Since previous small studies suggest an association of cognitive impairment with dialysis modality, we compared incident dementia among patients initiating hemodialysis (HD) vs peritoneal dialysis (PD) in a large national cohort.

methodsThis is a retrospective cohort study of incident dialysis patients in the United States from 2006 to 2008 with no diagnosis of dementia prior to beginning dialysis. We evaluated the effect of initial dialysis modality on incidence of dementia, diagnosed by Medicare claims data, adjusted for baseline demographic and clinical data from the USRDS registry.

resultsOur analysis included 121,623 patients, of whom 8,663 initiated dialysis on PD. The mean age of our cohort was 69.2 years. Patients who initiated PD had a lower cumulative incidence of dementia than those who initiated HD (1.0% vs 2.7%, 2.5% vs 5.3%, and 3.9% vs 7.3% at 1, 2, and 3 years, respectively). The risk of dementia for patients who started on PD was lower compared with those who started on HD, with a hazard ratio (HR) = 0.46 [0.41, 0.53], in an unadjusted model and HR 0.74 [0.64, 0.86] in a matched model.

conclusionsDialysis modality is associated with incident dementia in a cohort of older ESRD patients. This finding warrants further investigation of the effect of dialysis modality on cognitive function and evaluation for possible mechanisms.

Indexed as

Peritoneal DialysisAdolescentAdultAgedAged, 80 and overChildChild, PreschoolDementiaFemaleHumansIncidenceInfantInfant, NewbornKidney Failure, ChronicMaleMiddle Agedcognitive impairmentDementiaend-stage renal diseasehemodialysisperitoneal dialysis

Identifiers

PMID25742686
PMCPMC4406314

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.