Neurocognitive function in chronic hemodialysis patients

Pliskin, Neil H.; Yurk, Helene M.; Ho, Lam T.; Umans, Jason G.

doi:10.1038/ki.1996.202

Cited by 96 publications

(76 citation statements)

References 33 publications

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“…In univariate, parsimonious and multivariable models, there were no significant relationships between decreased cognitive function and lower Kt/V. Conclusion: In contrast to several older studies, there is no association between lower other more recent study failed to appreciate a link between dialysis adequacy and cognitive function [16][17][18] . Several of these studies have important limitations: the study of Kutlay et al [16] and colleagues used only the Mini-Mental State Examination (MMSE) for cognitive assessment while Pliskin et al [17] only studied 16 welldialyzed individuals.…”

Section: Introductioncontrasting

confidence: 42%

Cognitive Function and Dialysis Adequacy: No Clear Relationship

Giang¹,

Weiner²,

Agganis³

et al. 2010

Am J Nephrol

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Background/Aims: Cognitive impairment is common in hemodialysis patients and may be impacted by multiple patient and treatment characteristics. The impact of dialysis dose on cognitive function remains uncertain, particularly in the current era of increased dialysis dose and flux. Methods: We explored the cross-sectional relationship between dialysis adequacy and cognitive function in a cohort of maintenance hemodialysis patients. Adequacy was defined as the average of the 3 most proximate single pool Kt/V assessments. A detailed neurocognitive battery was administered during the 1st hour of dialysis. Multivariable linear regression models were adjusted for age, sex, education, race and other clinical and demographic characteristics. Results: Among 273 patients who underwent cognitive testing, the mean (SD) age was 63 (17) years and the median dialysis duration was 13 months, 47% were woman, 22% were African American, and 48% had diabetes. The mean (SD) Kt/V was 1.51 (0.24). In univariate, parsimonious and multivariable models, there were no significant relationships between decreased cognitive function and lower Kt/V. Conclusion: In contrast to several older studies, there is no association between lower Kt/V and worse cognitive performance in the current era of increased dialysis dose. Future studies should address the longitudinal relationship between adequacy of dialysis and cognitive function to confirm these findings.

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Section: Introductioncontrasting

confidence: 42%

Cognitive Function and Dialysis Adequacy: No Clear Relationship

Giang¹,

Weiner²,

Agganis³

et al. 2010

Am J Nephrol

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“…Some groups of questions can clearly distinct healthy persons from ones with MCI (20). Our findings correlate with other similar studies (21). Level of CRP in our study did not correlate significantly with global cognitive function unlike previous findings (22)(23)(24)(25).…”

Section: Discussioncontrasting

confidence: 54%

Analysis of Risk Factors for Development of Cognitive Disorders in Maintenance Hemodialysis Patients – Pilot Study

Todorović

Milovanovic

Drašković

et al. 2017

Serbian Journal of Experimental and Clinical Research

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“…Early studies among small samples of hemodialysis patients reported moderate rates of cognitive impairment across multiple cognitive domains, but often excluded older patients or those with stroke or severe comorbid conditions (4)(5)(6)(7)(8). One 1997 study using the relatively insensitive Mini Mental State Exam (MMSE) found that 30 percent of 336 hemodialysis patients aged 23 to 93 years had mild to severe cognitive impairment, using very conservative cut-points (9).…”

Section: Prevalence Of Cognitive Impairment In Hemodialysis Patientsmentioning

confidence: 99%

Cognitive Impairment in the Aging Dialysis and Chronic Kidney Disease Populations: An Occult Burden

Murray

2008

Advances in Chronic Kidney Disease

342

241

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The heavy burden of cognitive impairment in hemodialysis and chronic kidney disease patients has only recently become recognized. Up to 70 percent of hemodialysis patients ages 55 years and older have moderate to severe chronic cognitive impairment, yet it is largely undiagnosed. Recent studies describe the strong graded relation between estimated glomerular filtration rate (eGFR) and cognitive function in CKD patients. The process of conventional hemodialysis may induce recurrent episodes of acute cerebral ischemia, which in turn may contribute to acute decline in cognitive function during dialysis. Thus the worst time to communicate with dialysis patients may be during the hemodialysis session. Both symptomatic and occult, subclinical ischemic cerebrovascular disease appear to play a large role in a proposed model of accelerated vascular cognitive impairment in these populations. Severe cognitive impairment or dementia among hemodialysis patients is associated with an approximately two-fold increased risk of both mortality and dialysis withdrawal. Pre-dialysis cognitive screening and adding dementia to the list of comorbidities on Form 2728 would provide critical information regarding the benefit versus risks of receiving dialysis. It could also improve quality of care and outcomes by raising clinician's awareness of the potential effects of cognitive impairment on medication, fluid, and dietary compliance, and ability to make advance directive decisions among dialysis patients. While much remains to be learned regarding the pathophysiology of cognitive impairment in kidney disease, the public health implications of this substantial burden are immediate.

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Neurocognitive function in chronic hemodialysis patients

Cited by 96 publications

References 33 publications

Cognitive Function and Dialysis Adequacy: No Clear Relationship

Cognitive Function and Dialysis Adequacy: No Clear Relationship

Analysis of Risk Factors for Development of Cognitive Disorders in Maintenance Hemodialysis Patients – Pilot Study

Cognitive Impairment in the Aging Dialysis and Chronic Kidney Disease Populations: An Occult Burden

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