Chronic renal failure, dialysis, and neuropsychological function

Abstract

Hemodialysis patients, nondialyzed azotemic patients and control subjects with chronic physical disabilities were tested in psychometric measures of attention, memory, and visuomotor speed and coordination. There was relatively little difference between the performance of dialysis patients and controls and no significant correlations were found between years of dialysis treatment and performance on any task. In contrast, nondialyzed azotemic patients were impaired on 9 of 14 tasks relative to controls and/or dialysis patients. Measured levels of blood urea nitrogen (BUN) and serum creatinine were significantly correlated with the performance of nondialyzed azotemic patients on several tasks. These results demonstrate a relationship between degree of renal failure and cognitive and perceptual-motor functioning. The mild impairments evident in dialysis patients do not seem to be directly attributable to dialysis treatments. Rather, the onset of hemodialysis appears to have beneficial effects on neuropsychological function.

Moderate Chronic Kidney Disease and Cognitive Function in Adults 20 to 59 Years of Age

“…[1][2][3][4][5][6][7] Factors that may contribute to cognitive impairment in those with ESRD include a high prevalence of traditional cardiovascular risk factors that cause subclinical damage and uremia and its associated metabolic disturbances. 8 Increased risk for stroke 9 and carotid atherosclerosis 10,11 among those with ESRD may also predispose them to cognitive impairment.…”

Cognitive deficits of patients with chronic kidney disease and effect of hemodialysis

“…In a report by Hart et al (1983), non-dialyzed azotaemic patients were impaired on several tasks relative to dialysis patients. Thimmaiah et al (2012) reported improvement in neuropsychological measures of memory and attention 24 hours after hemodialysis.…”

“…Murray et al (2008), Kurella et al (2008), Hart et al(1983), Murray et al(2006), Kurella et al(2004). Prior studies examining CKD and cognitive function have reported an association of CKD with deterioration in cognitive function, incident dementia and impaired cognitive abilities related to verbal learning, visual attention, mental flexibility and executive functioning.…”

“…While some studies have reported positive effects of dialysis on at least some cognitive domains. Hart et al(1983), Umans and Pilskin(1998) according to Murray (2008), the dialysis procedure itself may worsen cognitive function. Only few reports on cognitive function of CKD patients exist in developing countries like Nigeria.…”

Lentidão cognitiva e psicomotora em hemodialisados crônicos

“…Como em outras encefalopatias subclínicas 9,10 , a característica essencial da encefalopatia urêmica subclínica (eus) é a lentidão cognitiva e psicomotora, mais acentuadas em pacientes em HDC e, em menor grau, naqueles submetidos a transplante renal. esses resultados concordam que a capacidade de sustentar a atenção e a velocidade do processamento mental são as funções cognitivas mais sensíveis à uremia crônica não tratada 11 .…”