UHDB researchers aiming to discover if cooling dialysis fluid can help preserve memory and brain function for patients
Researchers at University Hospitals of Derby and Burton (UHDB) are leading a new study to examine whether cooling the fluid used in dialysis can help preserve memory and thinking functions for patients undergoing the treatment - ultimately improving their long-term quality of life.
Haemodialysis is a life-sustaining treatment delivered, three times a week, to people whose kidneys are not working properly, filtering the waste and extra fluids from the patients' blood. Currently, 25,000 adults in the United Kingdom require haemodialysis.
More than two thirds of people undergoing haemodialysis experience problems with thinking and memory as their treatment progresses, which may ultimately lead to dementia. These issues tend to worsen more rapidly than in people who are not undergoing haemodialysis, and such decline in brain function can make it harder for people to do everyday tasks, increasing their reliance on others and lowering their overall quality of life.
With research showing that blood flow to the brain can drop during dialysis - which, if happening regularly, can harm the brain over time - one potential reason for the decline in thinking and memory for patients could be the dialysis treatment itself.
That has led Dr Tarek Eldehni, Consultant Nephrologist at Royal Derby Hospital, and a team of researchers from the UHDB Renal department and the University of Nottingham, to begin an innovative study which will examine whether lowering the fluid used in dialysis to 0.5 degrees Celsius below the individual's body temperature could help to preserve cognitive function.
Previous research done by the UHDB Renal team showed that using cooled dialysis fluid can have a positive effect in stabilising blood pressure and heart function during dialysis - so Dr Eldehni is looking forward to discovering what this next study could mean for people with serious kidney conditions.
"We are excited to conduct this important study. My interest in cooling the dialysis fluid goes back to my doctoral research work where we found that cooling the fluid by 0.5 degree below a person's body temperature can help protect the brain when they are undergoing haemodialysis, which we saw through brain MRI scans," he explained of the COOL-HD trial, which is receiving funding from the National Institute for Health and Care Research (NIHR) Research for Patient Benefit Programme, and is supported by the Derby Clinical Trials Support Unit.
"So building on our previous work, this new study will explore whether that brain protection also extends to preserving memory and thinking abilities. If successful, this approach could significantly improve the quality of life for people receiving haemodialysis, as it would be the first intervention that could benefit the memory and thinking in those people. Ultimately, this study has the potential to provide evidence that changes our clinical practice for the benefit of people receiving the treatment."
The team will study 356 participants across three centres (Derby, Nottingham and Leicester) with participants randomly allocated into receiving haemodialysis with a dialysate temperature of 0.5°C below their body temperature or haemodialysis with a dialysate temperature of 37°C for one year. The change in working memory will be assessed by Letter Number Sequencing tasks and various cognitive and quality of life assessments, with the results compared between the two groups of participants.
For more information on the study, you can contact the research study team involved by emailing uhdb.coolhdstudy@nhs.net