Home › Research › Health systems and care delivery
Impact of Conservative Management vs. Dialysis Transition on Cognition in a National Cohort of Patients with Advanced CKD
Seungsook You, Danh V. Nguyen, Yaara Zisman‐Ilani, Csaba Pal Kovesdy, Susan T. Crowley, Dana B. Mukamel, Alejandra Novoa Vargas, Yoko Narasaki et al.. Journal of the American Society of Nephrology, 2025-10-01
Topic: Risk, prevention and care in population studies
In 18,383 CM patients PS-matched to 18,383 dialysis patients, unadjusted Cox models showed dialysis transition was associated with higher risk of dementia, MCI, or combined dementia/MCI vs. CM: HRs (95%CIs) 1.40 (1.32-1.48), 1.64 (1.46, 1.85), and 1.42 (1.34, 1.49). Findings were robust in analyses doubly-adjusted for PS covariates (Fig 1A). Fine-Gray competing risk analyses showed dialysis was linked with higher risk of idementia, MCI, or combined dementia/MCI (ref: CM): SHRs (95%CIs) 1.32 (1.24, 1.39), 1.51 (1.34, 1.70), and 1.34 (1.27, 1.41). Cumulative incidence curves showed higher incident dementia risk with dialysis transition vs. CM (Fig 1B). In a national advanced CKD cohort, dialysis transition was associated with a higher dementia/MCI risk vs. CM. Further research is needed to identify strategies that mitigate cognitive decline in advanced CKD patients transitioning to dialysis. Funding: NIDDK Support
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
You, S., Nguyen, D. V., Zisman‐Ilani, Y., Kovesdy, C. P., Crowley, S. T., Mukamel, D. B., et al. (2025). Impact of Conservative Management vs. Dialysis Transition on Cognition in a National Cohort of Patients with Advanced CKD. Journal of the American Society of Nephrology. https://doi.org/10.1681/asn.2025384tq669
Vancouver
You S, Nguyen DV, Zisman‐Ilani Y, Kovesdy CP, Crowley ST, Mukamel DB, et al. Impact of Conservative Management vs. Dialysis Transition on Cognition in a National Cohort of Patients with Advanced CKD. Journal of the American Society of Nephrology. 2025. doi:10.1681/asn.2025384tq669.
BibTeX
@article{you2025-ef8594f7,
author = {You, Seungsook and Nguyen, Danh V. and Zisman‐Ilani, Yaara and Kovesdy, Csaba Pal and Crowley, Susan T. and Mukamel, Dana B. and Vargas, Alejandra Novoa and Narasaki, Yoko and others},
title = {{Impact of Conservative Management vs. Dialysis Transition on Cognition in a National Cohort of Patients with Advanced CKD}},
journal = {Journal of the American Society of Nephrology},
year = {2025},
doi = {10.1681/asn.2025384tq669},
url = {https://doi.org/10.1681/asn.2025384tq669}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- In 18,383 CM patients PS-matched to 18,383 dialysis patients, unadjusted Cox models showed dialysis transition was associated with higher risk of dementia, MCI, or combined dementia/MCI vs.
- CM: HRs (95%CIs) 1.40 (1.32-1.48), 1.64 (1.46, 1.85), and 1.42 (1.34, 1.49).
- Findings were robust in analyses doubly-adjusted for PS covariates (Fig 1A).
- Fine-Gray competing risk analyses showed dialysis was linked with higher risk of idementia, MCI, or combined dementia/MCI (ref: CM): SHRs (95%CIs) 1.32 (1.24, 1.39), 1.51 (1.34, 1.70), and 1.34 (1.27, 1.41).
- Cumulative incidence curves showed higher incident dementia risk with dialysis transition vs.
Why it matters
In this national cohort, patients with advanced chronic kidney disease who transitioned to dialysis had a higher risk of dementia or mild cognitive impairment than those managed conservatively. The study does not test any treatment, cure, or prevention for Alzheimer's disease.
Study details
- Evidence strengthModerate
How this study scored 35/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Society of Nephrology) |
| Journal's citation record | 3 / 4 | Journal of the American Society of Nephrology: journal h-index 370 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Connie M. Rhee: h-index 66 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Yale University: institution h-index 1,927 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 6 institution(s) in 1 country |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 35 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it.
Related
Studies in the library that share something with this one. The line above each title says what.
Related studies in Health systems and care delivery
Also tagged “controlled”
1,116 studies in the library carry the topic tag “controlled”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 1,116 tagged studies.