Low Hemoglobin Levels Tied to Higher Risk of Cognitive Impairment in Hemodialysis Patients: Study

Beyond hemoglobin levels, the study also examined a range of other variables such as education level, dialysis duration, comorbid conditions, serum albumin, creatinine, and interdialytic hypotension, all of which showed varying degrees of association with cognitive scores.

The authors pointed out that while anemia appears to be an independent factor associated with cognitive decline, the cross-sectional design of the study limits the ability to draw definitive conclusions about causality. They also noted several limitations, including the single-center setting, small sample size, and the use of the MMSE, which may not be sensitive enough to detect mild cognitive changes compared to other tools like the Montreal Cognitive Assessment (MoCA).

Despite these limitations, the study highlights the need for routine monitoring and effective management of hemoglobin levels in patients with ESRD on dialysis. Addressing anemia may not only improve physical health but also support cognitive well-being, which is essential for daily functioning and quality of life in this vulnerable population.

The researchers advocate for future multi-center, longitudinal studies with larger cohorts and more sensitive cognitive assessments to better understand the underlying mechanisms linking anemia and cognitive health in dialysis patients.

Reference:

Huang, L., Zhang, Y., Wang, J. et al. Association of anemia and cognitive impairment in patients undergoing maintenance hemodialysis: a cross-sectional study. BMC Nephrol 26, 387 (2025). https://doi.org/10.1186/s12882-025-04336-4