Grant: Doctoral Research Award: Canada Graduate Scholarships

Adults admitted to hospital intensive care units (ICUs) are more likely to develop problems with cognition. Cognition affects how people think, feel, and react. Problems with cognition can cause poorer quality of life, difficulties doing daily activities and caring for oneself, and strain the Canadian healthcare system. Patients who need dialysis for kidney issues during their ICU stay are at an even higher risk for these problems. Over half of critically ill patients develop kidney problems, and up to 13% need dialysis to replace the function of their kidneys. Patients who need long-term dialysis outside the ICU have worse cognitive function. We do not know the effect of short-term dialysis during an ICU admission on cognition. We expect the effect to be similar to long-term dialysis. Brain oxygen levels are linked to cognitive function and can be an early warning sign for cognitive problems. To understand how dialysis affects the brain in adults admitted to the ICU, we will a) measure the level of oxygen in the brain while patients are on dialysis; and b) see if these levels are associated with cognition and patient safety at 3- and 12-months after they have been discharged from the ICU. To understand any differences in brain effects, we will also compare the brain oxygen levels of patients when they are treated with two kinds of dialysis: intermittent hemodialysis (patients are treated for hours at a time with breaks in between), and continuous kidney replacement therapy (patients may be treated continuously for days with no breaks). Cognitive function is important for good quality of life. To support patients and the healthcare system, we need to know how treating patients with dialysis in the ICU impacts their cognition. This will help providers and patients make more informed decisions about both the type and the impact of dialysis. This study may inform future interventions to help prevent cognitive problems for patients treated with dialysis in the ICU.