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Objectives: In the general population aortic stiffening assessed by carotid femoral pulse wave velocity (cf-PWV) is associated with cognitive dysfunction (CO/DY). Data in chronic kidney disease (CKD) are limited. Our study tests the hypothesis that large artery stiffness and microvascular damage in CKD patients are related to brain microcirculation changes reflected by impaired cognitive function. Methods: Among 244 patients, finally 44 with CKD stage 1; 47 stage 2; 25 stage 3; 35 stage 4, with mean age 58.4 years (64.5% males), were enrolled in a cross-sectional study. Cognitive impairment measured by Mini Mental State Examination (MMSE), Clock – drawing test (Clock-test), and Instrumental Activity of Daily Living (IADL) was considered as primary outcome. We directly measured brachial, aortic, systolic blood pressure, pulse pressure, mean blood pressure and cf-PWV. Results: Our patients revealed a significant linear deterioration in all the domains of cognitive function according to CKD stages, assessed by MMSE, Clock-test and IADL. The risk of cognitive dysfunction increased significantly from CKD stage 3 to 4 (p

Objective: Patients in hemodialysis frequently have cognitive dysfunction (CO/DY). Hemodialysis session often results in acute intravascular volume loss, fluid shifts, hypotensives episodes, decrease of cerebral perfusion and cerebral ischemia, all of which may cause transient deterioration of cognitive function. On the contrary, improvement in “uremic milieu” after a dialysis session can result in improved cognition. The aim of this study is to evaluate the effect of a single, random hemodialysis session on cognitive function, in absent of hypotensive episodes. Method: Global cognitive function was assessed, pre-and post-dialysis by using the Mini Mental State Examination. Results: Forty-eight patients participated in the study. The average age was 60.8±13.4 years. The mean dialysis vintage was 58±66 months. Patients received adequate renal replacement therapy and the mean urea reduction ratio was 72±6.6. At the onset and at the end of the study, no major hemodynamic changes were detecting (mean systolic/diastolic blood pressure (147.±20/78±11 vs 138±20/77±10 mmHg) according to our aforementioned criteria. Compared to pre- dialysis, an improvement in the test score was revealed after dialysis, paired t-test (p=0.03). Mean values of MMSE pre and post was 26.61 ± 3.24 and 28.86± 1.98 respectively (amelioration of 2.25 points). Conclusions: Our results illustrate the better performance of cognitive function that can be observed after a single dialysis session, in absent of hypotensives episodes. These results may be used as a starting point, in an effort to evaluate the best possible time, pre or post dialysis, to provide medical advice to these patients.