Prevalence of mild cognitive impairment in automated peritoneal dialysis patients

Abstract

Background Cognitive deterioration decreases quality of life, self-care and adherence to treatment, increasing mortality risk. There is scarce information of cognitive impairment in peritoneal dialysis, and data are controversial. Objective To determine the frequency and associated factors of cognitive impairment in patients on automated peritoneal dialysis (APD). Methods Cross-sectional study; 71 patients on APD underwent clinical, biochemical and cognitive function evaluation by means of the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Cognitive function was also evaluated in healthy controls. Results Mean age was 42 ± 16 years, 79% were men and dialysis vintage was 17 (7-32) months. In APD patients, cognitive impairment was present in 7% (mild deterioration) and 68% according to the MMSE and MoCA, respectively, and in 4% and 37% in the healthy controls. Patients with cognitive impairment (according to MoCA) were older, with lower educational degree, had more frequently diabetes, and higher serum glucose, as well as lower serum creatinine, phosphorus and sodium concentrations than patients with normal cognitive function. In multiple linear regression analysis, predictors for the MoCA score (R2 0.63, p = 0.002) were schooling [B = 0.54 (0.20 to 0.89), p = 0.003], age [B=-0.11 (-0.21 to -0.01), p = 0.04], serum sodium [B = 0.58 (0.05 to 1.11), p = 0.03] and creatinine concentrations [B = 3.9 (0.03 to 0.83), p = 0.03]. Conclusion In this sample of APD patients with mean age in the early 40 s, the prevalence of cognitive impairment by MoCA test was 65%, and it was associated to older age, lower educational level and lower serum concentrations of sodium and creatinine.

Left ventricular hypertrophy, carotid atherosclerosis, and cognitive impairment in peritoneal dialysis patients

“…CAS is not an independent risk factor for CI in patients undergoing PD. The prevalence of CI based on MoCA scores in this PD population was 56%, which is similar to the percentages reported by Salazar-Felix [51] and Yi et al [52] (65% and 49.9%, respectively). In addition, a systematic review and meta-analysis showed that the prevalence of CI in patients undergoing PD ranged from 3.3% to 74.5% [53], which could be attributed to the different neuropsychological tests used.…”

Prevalence of Cognitive Impairment in Peritoneal Dialysis Patients and Associated Factors

“…It seems that the CI of patients on RRT may be underdiagnosed. Moreover, little is known about the prevalence of CI in patients undergoing PD [12] . Patients on PD with cognitive problems might not be able to continue this form of dialysis.…”

Performance of dialysis patients on the standard and basic Arabic versions of the Montreal Cognitive Assessments

“…[8][9][10][11] Dialysis patients have a high burden of vascular disease, and cognitive impairment from cerebrovascular disease is common in patients undergoing either hemodialysis )HD( or peritoneal dialysis )PD(. 12 The pathophysiology may be attributed to microinflammation, malnutrition, and uremic metabolites. [12][13][14] Detecting cognitive impairments in dialysis patients is imperative.…”

“…12 The pathophysiology may be attributed to microinflammation, malnutrition, and uremic metabolites. [12][13][14] Detecting cognitive impairments in dialysis patients is imperative. Lee et al 9 found that patients with varying degrees of severity of cognitive impairment are likely to go unnoticed and probably don't voice any concerns.…”

“… 12 The pathophysiology may be attributed to microinflammation, malnutrition, and uremic metabolites. 12 – 14 …”