Research Papers: Gerotarget (Focus on Aging):

End stage renal disease is associated with development of dementia

Peir-Haur Hung, Chih-Ching Yeh, Chih-Yen Hsiao, Pi-Shan Sung, Chih-Hsin Muo, Fung-Chang Sung, Kuan-Yu Hung and Kuen-Jer Tsai _

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Oncotarget. 2017; 8:107348-107355. https://doi.org/10.18632/oncotarget.22458

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Peir-Haur Hung1,2, Chih-Ching Yeh3,4, Chih-Yen Hsiao1,5, Pi-Shan Sung6,7, Chih-Hsin Muo8, Fung-Chang Sung8,9, Kuan-Yu Hung10 and Kuen-Jer Tsai6,11

1Department of Internal Medicine, Ditmanson Medical Foundation Chia-yi Christian Hospital, Chia-yi, Taiwan

2Department of Applied Life Science and Health, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan

3School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan

4Department of Public Health, China Medical University, Taichung, Taiwan

5Department of Hospital and Health Care Administration, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan

6Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan

7Department of Neurology, National Cheng Kung University Hospital, Tainan, Taiwan

8Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

9Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan

10Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu City, Taiwan

11Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

Correspondence to:

Kuen-Jer Tsai, email: [email protected]

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


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.

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