Cognitive Impairment is Associated with Mortality in Hemodialysis Patients

Angermann, Susanne; Schier, Johannes; Baumann, Marcus; Steubl, Dominik; Hauser, Christine; Lorenz, Georg; Günthner, Roman; Braunisch, Matthias C.; Kemmner, Stephan; Satanovskij, Robin; Haller, Bernhard; Heemann, Uwe; Lehnert, Thomas; Bieber, Richard; Pachmann, Martin; Braun, Jürgen R.; Scherf, Julia; Schätzle, Gabriele; Fischereder, Michael; Grimmer, Timo; Schmaderer, Christoph

doi:10.3233/jad-180767

Cited by 36 publications

(38 citation statements)

References 34 publications

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“…Most importantly, CI is an independent predictor of all‐cause mortality in maintenance hemodialysis (MHD) patients. Long‐term HD also resulted in a significant almost threefold higher hazard for all‐cause mortality (Angermann et al, ). In spite of these, it is not paid enough attention by nephrologists yet (Kurella Tamura & Yaffe, ), which should raise awareness about the associated factor causing CI in this population.…”

Section: Introductionmentioning

confidence: 99%

Uric acid is associated with cognitive impairment in the elderly patients receiving maintenance hemodialysis—A two‐center study

Tang

Wang

et al. 2020

Brain and Behavior

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Background Elevated serum uric acid (SUA) has been associated with vascular cognitive impairment (CI) in the elderly. However, its relationship with cognitive function in the elderly patients receiving maintenance hemodialysis (MHD) has not yet been elucidated. Objective The cognitive impairment is prevalent in MHD patients. Various insults may contribute to cognitive impairment in patients with MHD. The aim of this study was to investigate the relationship between SUA and CI in the elderly patients receiving MHD. Methods A total of 180 elderly MHD subjects from two hospitals were enrolled in our study. Cognitive function domains were evaluated by MMSE at the beginning of the trial. Demographic and clinical characteristics were collected and recorded. Results The subjects were stratified into quartiles according to SUA level. Demographic and clinical characteristics such as age, gender, smoking habit, education year, blood pressure (BP), hemoglobin, albumin, blood glucose (BG), total cholesterol (TC), triglycerides (TG), high‐density lipoprotein cholesterol (HDL), low‐density lipoprotein cholesterol (LDL), blood urea nitrogen (BUN), and serum creatinine (Scr) did not differ dramatically among groups (p > .05). The Q1 group showed the highest MMSE scores, and the Q4 group showed the lowest MMSE sores (p < .05). There was a negative correlation between SUA and MMSE scores (r = −.307, p = .014), and this correlation was independent of demographic and clinical characteristics. Conclusions Elevated SUA maybe contributes to CI in the elderly MHD patients. SUA level is independent risk for the CI in the elderly MHD patients.

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Section: Introductionmentioning

confidence: 99%

Uric acid is associated with cognitive impairment in the elderly patients receiving maintenance hemodialysis—A two‐center study

Tang

Wang

et al. 2020

Brain and Behavior

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“…Reports from the USA and Italy show that cognitive impairment prevalence in hemodialysis patients ranged from 70 to 80% in the last 10 years, which were relatively higher than those individuals with normal kidney function 3 , 4 . Besides, previous studies have linked cognitive impairment with adverse outcomes that can potentially influence hemodialysis patient’s compliance regarding their dialysis schedules and medication regimens 5 , 6 .…”

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confidence: 99%

Cognitive impairment and associated risk factors in older adult hemodialysis patients: a cross-sectional survey

Luo

Murray

Guo

et al. 2020

Sci Rep

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The clinical epidemiological features of cognitive impairment in Chinese older adult patients undergoing hemodialysis are not clear, we aimed to identify the extent and patterns of cognitive impairment among those patients. We conducted a cross-sectional study of 613 hemodialysis patients aged 50 to 80 from 11 centers in Beijing. A neuropsychological battery of 11 tests covering domains of attention/processing speed, executive function, memory, language, and visuospatial function was applied, patients were classified as none, mild, or major cognitive impairment according to the fifth version of the Diagnostic and Statistical Manual of Mental Disorders criteria for cognitive impairment. Compared with Chinese population norms, 37.2% of the participants had mild cognitive impairment, 43.7% had major cognitive impairment. Memory and language were the most severe impaired domains in the mild cognitive impairment group, attention and visuospatial function domains were the most serious impaired domains in the major cognitive impairment group. Concomitant impairment across multiple cognitive domains was common. Factors associated with major cognitive impairment included age, education level, history of stroke and hypertension, dialysis vintage, and single-pool Kt/V. There is a high frequency of cognitive impairment in Chinese older adult hemodialysis patients, with varying severity and concomitant impairment across multiple domains.

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“…The MOCA scores were categorized as “Pass” if patients scored 25 or greater or “Fail” if less than 25. This is based on standard reporting of several studies in patient with end‐stage renal disease 20,25 …”

Section: Methods/materialsmentioning

confidence: 99%

Can the Timed Up & Go Test and Montreal Cognitive Assessment predict outcomes in patients waitlisted for renal transplant?

Bozhilov

2020

Clinical Transplantation

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Purpose Frail patients who undergo renal transplantation (RT) have more complications; however, little is known if these patients can sustain the wait to RT. We used the Timed Up and Go Test (TUGT) and Montreal Cognitive Assessment (MoCA) to determine outcomes of RT candidates. Methods In this retrospective study, 526 RT candidates underwent TUGT and MoCA (2015‐2019) and were divided into “favorable” (transplanted or remained on the list) or “unfavorable” (not listed, removed from list, or died) outcome. Demographics, education, language, comorbidities, dialysis type, use of a walking device, TUGT, and MoCA were compared by outcome. Results Overall, 230 patients (43.7%) passed TUG, 268 (51%) passed MoCA, 133 (25.3%) passed both, and 161 (30.6%) failed both tests. Multivariate analysis demonstrated age ≥ 65 (OR 1.58, CI 1.03–2.43), cardiac disease (OR 3.09, CI 2.02–4.72), ≥36 months on dialysis (OR 1.80, CI 1.24–2.69), EPTS < 20% at time of MoCA (OR 0.26, CI 0.07–0.98), and failing TUGT (OR 2.14, CI 1.43–3.19) were associated with unfavorable outcome. Failing MoCA was not associated with outcome. Conclusions MoCA test results were not associated with RT waitlist outcomes; however, passing the TUGT was associated with receiving RT or remaining on the list. Additional studies are needed to validate this and determine outcome after RT.

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Cognitive Impairment is Associated with Mortality in Hemodialysis Patients

Cited by 36 publications

References 34 publications

Uric acid is associated with cognitive impairment in the elderly patients receiving maintenance hemodialysis—A two‐center study

Uric acid is associated with cognitive impairment in the elderly patients receiving maintenance hemodialysis—A two‐center study

Cognitive impairment and associated risk factors in older adult hemodialysis patients: a cross-sectional survey

Can the Timed Up & Go Test and Montreal Cognitive Assessment predict outcomes in patients waitlisted for renal transplant?

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