# Intra-dialytic cerebral oximetry and cognitive decline in adults on hemodialysis

> **NIH NIH K23** · MEDICAL COLLEGE OF WISCONSIN · 2020 · $176,911

## Abstract

Project Summary/Abstract
The objective of this proposal is to provide Dr. Wolfgram a pathway to independence as a clinical investigator
and expert in the field of cognitive and functional outcomes in adults on dialysis. The overall goal of Dr.
Wolfgram is to improve the health and well-being of patients with end stage renal disease (ESRD) treated with
hemodialysis (HD) by dedicating her career to evaluation, prevention and management of the cognitive and
functional impairment that is highly prevalent in the HD population. In this proposal Dr. Wolfgram will focus on
evaluation of a HD process-specific risk factor for cognitive decline in a HD cohort. The current literature and
Dr. Wolfgram’s prior work suggest that, in addition to traditional patient risk factors for cognitive impairment, the
HD process may further contribute to cognitive decline. Conventional HD causes circulatory stress that can
lead to perfusion abnormalities and ischemic injury in end-organs. Brain injury, specifically, may occur due to
changes in cerebral perfusion during HD. Patients on HD may have impaired cerebral auto-regulation due to
vascular disease from common comorbid conditions such as diabetes, hypertension, and older age and from
ESRD-specific risk factors such as vascular calcification from impaired calcium and phosphate regulation.
Cerebral hypo-perfusion may occur during HD sessions due to systemic hemodynamic fluctuation in the setting
of impaired cerebral autoregulation. This may lead to cerebral ischemic injury and subsequent cognitive
decline. In this proposal Dr. Wolfgram will conduct a prospective cohort study evaluating intradialytic change in
cerebral perfusion as a risk factor for decline in cognitive status. Dr. Wolfgram will use cerebral oximetry,
measured by near-infrared spectroscopy, as an index for cerebral perfusion during HD sessions. She will
evaluate three cognitive focused outcomes 1) cerebral white matter integrity measured with brain MRI, 2)
cognitive performance measured with neuropsychological tests in the NIH Toolbox cognition battery, and 3)
patient reported cognitive function measured with the Patient Reported Outcomes Measurement Information
Systems. Results of this study will determine if changes in cerebral oximetry during HD are predictive of
decline in cognitive outcomes overtime, and potentially identify a target for future therapeutic intervention
aimed at reducing cognitive decline. In order to complete this study and achieve her goal of developing
expertise in clinical outcomes research in the HD population Dr. Wolfgram will follow a career development
training plan focused on research methodology, cerebral imaging, neuropsychology, and patient reported
outcome measures. Her training will be guided by her mentor and advisors at the Medical College of
Wisconsin, the Berman Center for Clinical Outcomes Research and Marquette University. Completion of this
research proposal along with the formal training activities will allow Dr...

## Key facts

- **NIH application ID:** 9869892
- **Project number:** 5K23DK113119-03
- **Recipient organization:** MEDICAL COLLEGE OF WISCONSIN
- **Principal Investigator:** Dawn F. Wolfgram
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $176,911
- **Award type:** 5
- **Project period:** 2018-03-15 → 2023-03-14

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9869892

## Citation

> US National Institutes of Health, RePORTER application 9869892, Intra-dialytic cerebral oximetry and cognitive decline in adults on hemodialysis (5K23DK113119-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9869892. Licensed CC0.

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