Cognitive Function and Dialysis Adequacy: No Clear Relationship (original) (raw)
Relationship between dialysis adequacy and cognitive function in hemodialysis patients
Ukrainian Journal of Nephrology and Dialysis
The prevalence of cognitive impairment is extremely high in dialysis patients, and it has been hypothesized that low urea clearance has an impact on cognitive impairment. However, several other studies conducted in the era of high-flux dialysis have not shown an association between lower Kt/V and poorer cognitive function. Therefore, studies that directly examine the relationship between dialysis adequacy and cognitive function in hemodialysis patients are essential. The present study aimed to investigate the cognitive functions of hemodialysis patients and their relationship with dialysis adequacy. Methods. This cross-sectional observational study included 100 patients and 100 healthy volunteers. Dialysis adequacy was assessed by the Kt/V ratio in the previous month. The Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment Test (MoCA), and the Clock Drawing Test (CDT) were used to assess cognitive function. Multiple regression analysis was used to determine the s...
American Journal of Kidney Diseases, 2007
Background: Although cognitive function in hemodialysis patients is believed to be best 24 hours after the dialysis session, the extent of variation during the dialysis cycle is unknown. Study Design: Cohort study with repeated measures. Setting & Participants: Hemodialysis centers; patients aged 55 years or older. Predictor: Time of assessment related to the dialysis session. Time 1 (T1) occurred approximately 1 hour before the dialysis session; T2, 1 hour into the session; T3, 1 hour after; and T4, the next day. Outcomes: Measures of cognitive function using a 45-minute cognitive battery. An average composite score was calculated to measure global cognitive function, equal to the average of subjects' standardized scores on all tests given at each test time. Times were classified as best and worst according to composite scores. Measurements: Testing was conducted on average over 2 dialysis sessions to avoid test fatigue. The cognitive battery included tests of verbal fluency, immediate and delayed verbal and visual memory, and executive function, administered at 4 times. Results: In the 28 subjects who completed testing at 3 or 4 testing times, mean age was 66.7 Ϯ 9.5 years and mean dialysis vintage was 44.7 Ϯ 33.3 months. Using a general linear model for correlated data, the composite score was significantly lower (poorer) during dialysis (T2) than shortly before the session (T1) or on the next day (T4; P Ͻ 0.001 for both). Limitations: Relatively small sample size, testing delays, results may not be generalizable. Global cognitive function varies significantly during the dialysis cycle, being worst during dialysis and best shortly before the session or on the day after. Clinician visits may be most effective at these times.
Indonesian Journal of Kidney and Hypertension
Background: The incidence of cognitive impairment (CI) has been widely reported in various studies among chronic kidney disease (CKD) patients. Many factors influence cognitive function including the hemodialysis (HD) process itself. There is much evidence that a single HD session brings about changes in the cognitive status of patients, but just a few studies assessing whether cognitive performance varies with dialysis. Aim: To know the effect of single dialysis session on cognitive function in HD patients. Method: Sixty medically stable CKD stage 5 patients on HD maintenance for at least three months were enrolled. Cognitive testing performed thrice, 1-2 hour prior to dialysis (T1), 3-4 hour into the session (T2) and 24 hour after the session (T3) using a wellvalidated neuropsychological test battery, Montreal Cognitive Assessment (MoCA) Indonesian version which assess the domain of cognitive function including visuospatial, executive function, naming, memory, attention, language, abstraction, recall, and orientation. Result: Subjects' mean age was 45,45 ± 11,28 years, dialysis vintage 10,12 ± 11,88 months, 44 patients (73,3%) had CI at baseline. Cognitive function decline during dialysis (T2) (MoCA INA score 21,65 to 19,67, p < 0.001) and visuospatial, executive function, attention, language and recall was impaired during dialy-sis. Cognitive function reached its best 24 hour after dialysis (MoCA INA score 23,65, p < 0.001) and all the domain of cognitive function was improved except naming that didn't change over the dialysis session. Conclusion: There is an effect of single HD session on global cognitive function where executive function, attention, language, and recall deteriorated during HD while abstraction and orientation didn't change. All cognitive domains were recovered 24 hours after HD except naming that didn't change from baseline throughout the whole process.
Cognitive function in dialysis patients
American Journal of Kidney Diseases, 2005
There are few detailed studies of cognitive function in dialysis patients. However, appreciating the prevalence and risk factors for cognitive impairment is important because cognitive impairment may decrease an individual&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s quality of life, increase resource utilization, and result in suboptimal medical care because of difficulty following caregiver recommendations. Cognitive impairment also is likely to become more of a problem as the dialysis population ages. In this review, we argue that cerebrovascular disease is an important cause of cognitive impairment in dialysis patients and discuss risk factors specific for vascular disease, as well as other factors that may influence cognitive function. We describe the structural brain abnormalities frequently seen in dialysis patients and the specific neurocognitive changes noted in prior studies. We explore potential measures to reduce cognitive impairment in this population. We conclude that additional research is needed in this area.
A study on cognitive status in chronic kidney patients on dialysis
IP innovative publication pvt. ltd, 2019
Introduction: Cogitive impairment is common in uremia and diabetes mellitus. Cognitive impairment affects the activities of daily living in most of chronic kidney disease patients. As per literature, cognitive impairment is less common in non-diabetic than diabetic of chronic kidney disease. There is sparse data regarding incidence and pattern of cognitive impairment in chronic kidney disease patients with regard to mode of dialysis either hemodialysis or peritoneal dialysis. Aim and Objectives: Aim : To estimate the pattern and prevalence of cognitive impairment in chronic kidney patients on dialysis. Objectives: 1) To compare the pattern of cognitive impairment between hemodialysis and peritoneal dialysis patients. 2) T o study the impact of glycemic status on cognitive impairment in chronic kidney disease patients. Material and Methods: A prospective cross-sectional observational study conducted at MGM hospital/Kakatiya medical college during May 2016 through December 2017 on chronic dialysis patients who fulfilled the inclusion and exclusion criteria. All the cases were subjected to Cognitive assessment by applying ACE- R adapted to Telugu speaking people. Results: 1) In our study the prevalence of dementia and mild cognitive impairment (MCI) were 47% & 21% respectively. 2) Among 47 dementia patients 31(66%) were diabetic, 25(53%) were undergoing hemodialysis and 22(46%) were undergoing peritoneal dialysis. 3) The pattern of cognitive decline was memory (89%), language (78%), visuospatial (68%), attention (57%), and fluency (57%). Conclusions: Present study highlighted not only the burden of cognitive decline in the dialysis patients where hemodialysis and presence of diabetic were significantly associated with dementia.
Cognitive Impairment in Peritoneal Dialysis Patients
American Journal of Kidney Diseases, 2011
Background-Prevalence of moderate to severe cognitive impairment among hemodialysis patients is more than double the prevalence in the general population. This study describes cognitive impairment occurrence in a peritoneal dialysis cohort compared with a cohort without chronic kidney disease (CKD). Study Design-Cross-sectional study. Setting and Participants-51 English-speaking peritoneal dialysis patients from two urban dialysis units, compared with 338 hemodialysis patients from 16 urban dialysis units and 101voluntary controls without CKD from urban general medicine clinics. Predictor-A 45-minute battery of nine validated neuropsychological tests (cognitive domains memory, executive function, language).
Pakistan Armed Forces Medical Journal, 2018
Objective: To determine the prevalence and association of cognitive decline among the patients of chronic kidney disease (CKD) undergoing hemodialysis.Study Design: Cross-sectional study.Place and Duration of Study: Military Hospital Rawalpindi, between Jul to Dec 2016.Material and Methods: The sample population comprised of patients of chronic kidney disease (CKD) under-going hemodialysis at a tertiary care hospital in Rawalpindi, Pakistan. Cognitive decline was assessed by using the British Columbia Cognitive Complaints Inventory (BC-CCI). Relationship of age, gender, marital status, psychiatric morbidity, education, occupation, BMI, duration of dialysis, dialysis count per week, level of family income, use of naswar and tobacco smoking was assessed with the presence of cognitive decline.Results: Out of 140 patients screened through BC-CCI, 86.4% showed the presence of cognitive decline while 13.6% had no cognitive decline. After applying the logistic regression we found that psyc...
2021
Introduction Prevalence of cognitive impairment increases with worsening severity of chronic kidney disease (CKD) and majority of end-stage kidney disease (ESKD) patients on dialysis have cognitive impairment. Trends of cognitive function (CF) in this population are less well known with published studies reporting conflicting results. Methods We assessed CF in a cohort of non-dialysis CKD and ESKD patients undergoing dialysis using modified mini-mental state examination (3MS), trail-making test (TMT-A & B) scores and Stroop task, and evaluated demographics, comorbidities and depression using Beck depression inventory at baseline. We repeated tests of CF and depression ≥ 1-year after baseline in both groups and compared change scores in CF and depression between ESKD/ CKD sub-groups. Among ESKD patients we compared change scores between patients with dialysis vintage of <1-year and >1-year. Analysis of covariance was used to adjust for the effect of age on these change scores. ...
Caspian Journal of Neurological Sciences, 2017
Background: Hemodialysis is a treatment for end-stage renal disease (ESRD) that is an underlying factor of cognitive impairment in patients. Objectives: This study was conducted to evaluate the prevalence of cognitive impairment and its associated factors in patients undergoing hemodialysis using Montreal Cognitive Assessment (MoCA). Materials and Methods: This cross-sectional study was carried out in 2016 in the dialysis unit of an academic hospital in the north of Iran. A total of two hundreds and twenty-four patients with chronic renal failure and ESRD presenting to for hemodialysis were included. All the patients were evaluated by the MoCA and the cutoff point was set at ≤25 for confirming cognitive impairment. The data obtained were analyzed in SPSS-18 using the Chi-square test, Mann-Whitney's U-test, Fisher's exact test, the independent t-test and the binomial logistic regression. Results: From the total of 224 patients examined, 93 (41.52%) had developed cognitive impairment. The variables of age, stroke, education and diabetes were entered into the logistic regression model to analyze the associated risk factors, but only age and a history of stroke showed a significant relationship with this impairment; that is, the possibility of cognitive impairment increases with increasing age and a history of stroke can increase its risk six-fold. Conclusion: Cognitive impairment was a relatively frequent complication of hemodialysis in this study which was performed in the north of Iran. Aging and a history of stroke are risk factors of cognitive impairment in patients with chronic kidney failure undergoing hemodialysis treatment.