Wolfgram DF, Novotny J, Goodman MJ, et al. - In this cross-sectional study, researchers looked at changes in cerebral perfusion as well as an index of cerebral autoregulation (CA index) during hemodialysis (HD) to identify potential risk factors for intradialytic decline in cerebral perfusion and impaired cerebral autoregulation. HD patients age 50 years or older receiving conventional in-center HD were included. They used cerebral oximetry to measure cerebral perfusion during HD and calculated the correlation between cerebral perfusion and blood pressure (BP) during HD as an index of CA. The analysis included 32 participants and 118 HD sessions. Cerebral perfusion can decrease during HD and is linked to changes in systemic BP. This could be because HD patients have impaired cerebral autoregulation. Diabetes and > 20 mmHg drop in SBP during HD are risk factors for a worse CA index. This study emphasizes the dangers of intradialytic decline in cerebral perfusion and impaired cerebral autoregulation in patients with HD.