Enhanced Dialysis Approach Linked to Better Cognitive Scores, Fewer Toxins

TUESDAY, Nov. 25, 2025 (HealthDay News) – Triple-modality dialysis combining hemodialysis, hemodiafiltration, and hemoperfusion is associated with better cognitive scores and greater reductions in protein-bound uremic toxins among patients on maintenance hemodialysis, according to a study published online Nov. 25 in Renal Failure. Maozhu Wang, from The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College in Chongqing, China, and colleagues conducted a randomized study of 135 adults undergoing maintenance hemodialysis who were assigned to hemodialysis (HD), HD plus hemodiafiltration (HD+HDF), or HD+HDF plus hemoperfusion (HD+HDF+HP). Investigators assessed cognitive function using the Mini-Mental State Examination and the Montreal Cognitive Assessment and measured plasma homocysteine and indoxyl sulfate before and after dialysis sessions. Group comparisons, correlation analyses, multivariable regression, and receiver operating characteristic curve analysis were performed. The authors report that cognitive scores improved progressively across the three groups, with the greatest improvement in the HD+HDF+HP group. Levels of homocysteine and indoxyl sulfate decreased accordingly and were lowest with HD+HDF+HP. In multivariable analyses, both toxins were identified as independent risk factors for cognitive impairment, and receiver operating characteristic analyses indicated strong predictive value for cognitive decline. “The results indicate that combined HDF and HP enhances removal of protein bound toxins and is associated with better preservation of cognitive function,” the investigators write. Abstract/Full Text.Sign up for our weekly HealthDay newsletter