極高比例的末期腎病變患者具有不等程度的認知功能障礙，卻時常未被診斷。研究發現認知功能障礙與日後發生死亡與住院等不良預後高度相關。可能的致病機轉和腦血管疾病、尿毒素累積、透析中低血壓以致反覆腦部缺血性傷害、睡眠障礙及憂鬱等等相關。一線醫護人員應保持高度警覺，留意透析病人是否出現認知障礙的症候，排除其他影響意識的原因後，進行簡易認知功能篩檢，需要時轉介神經專科醫師進一步確診，並調整病患照護模式，考慮降低透析液溫度以減少透析中低血壓發生。希望藉由早期診斷、早期介入，改善病人的生活品質，並且減少認知功能障礙對於照顧者及加諸於社會經濟的龐大負擔。

Cognitive impairment is prevalent in patients with end-stage renal disease but it is usually underdiagnosed. Previous studies revealed that cognitive impairment is significantly associated with adverse health outcomes, including all-cause mortality and hospitalization. The possible etiologies include the high incidence of cerebrovascular diseases, accumulation of uremic toxins, repeating brain ischemic injury caused by intradialytic hypotension, sleep disorders and depression. Medical staff should be alert to signs and symptoms of cognitive impairment, conduct screening neurocognitive testing after treatable factors corrected, and refer patients to neurologists for further assessment and diagnosis whenever necessary. Health care planning should be individualized for patients with cognitive impairment, and lowering dialysate temperature may be considered to prevent intradialytic hypotension. By performing the integration of early diagnosis and intervention, we can improve life quality of the patients and ameliorate enormous burden on care givers, healthcare systems and society.