Long-term cognitive impairments in kidney transplant recipients: impact on participation and quality of life

Abstract

Background Cognitive impairment is often present shortly after transplantation in kidney transplant recipients (KTR). To date, it is unknown whether these impairments persist on the long term, to what extent they are associated with disease related variables and whether they affect societal participation and quality of life (QoL) of KTR. Method This study was part of the TransplantLines Biobank & Cohort study in the University Medical Center Groningen. 131 KTR, with a mean age of 53.6 years (SD = 13.5) transplanted ≥ 1 year ago (M = 11.2 years, range 1–41.7 years), were included, and compared to 306 healthy controls (HC). KTR and HC were well-matched; there were no significant differences regarding age, sex and education. All participants were assessed with neuropsychological tests measuring memory, mental speed, attention and executive functioning, and with questionnaires examining societal participation and QoL. Results Compared to HC, KTR performed significantly worse on memory, mental speed and measures of executive functioning (all p-values < 0.05). Moreover, 16% of KTR met the criteria for mild cognitive impairment (MCI), compared to 2.6% of the HC. MCI in KTR was not significantly correlated with age and disease related variables. Poorer cognitive functioning was significantly related to lower levels of societal participation and to lower QoL (all p-values < 0.01). Conclusions This study shows long-term cognitive impairments in KTR which are not related with disease related variables. Neuropsychological assessment is important to timely signal these impairments, given their serious negative impact on societal participation and QoL.

Postoperative cognitive dysfunction in heart transplantation recipients

“…13 Additionally, approximately 16% of kidney transplant recipients met the criteria for mild cognitive impairment, compared to 2.6% of healthy controls, and patients with poorer cognitive function exhibited reduced social participation and diminished quality of life. 14 Postoperative NCD is prevalent following lung transplantation, affecting around 50%-67% of recipients, depending on the timing and method of assessment. 15 17 Consequently, this study employed a combination of both scales to enhance the screening of patients with postoperative NCD.…”

Effect of Intravenous Ferric Carboxymaltose on Exercise Capacity After Kidney Transplantation (EFFECT-KTx): rationale and study protocol for a double-blind, randomised, placebo-controlled trial

“…Additionally, the study provides an opportunity to assess the effect of iron supplementation on several other organ systems and physical functions. First, correction of ID might improve neurocognitive functions such as memory, mental speed and executive functioning, which are compromised after kidney transplantation 43 44. In addition to its role in energy metabolism, iron is involved in neurotransmitter synthesis and uptake and neuron myelination 45.…”

Current recommendations regarding evaluation of cognitive functioning in organ transplant candidates

“…dialysis) [1–8]. Although exact mechanisms across organ systems are not yet fully understood, these impairments are associated with negative effects on patient and their families’ functioning and patient clinical outcomes including mortality [9,10 ▪▪ ,11–15]. As a result, national guidelines recommend pretransplant assessment of cognitive functioning [16–18].…”