Cognitive outcome following kidney transplantation

Gelb, Shannon R.; Shapiro, R. Jean; Hill, A. T.; Thornton, Wendy Loken

doi:10.1093/ndt/gfm659

Cited by 52 publications

(70 citation statements)

References 17 publications

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“…Our findings of improved cognitive and psychomotor performance after kidney transplantation are similar to the results from previous researches indicating a positive effect of kidney transplantation on cognitive function [11,12,13,15,16,29,30]. But, most of the previous studies have suffered from a lack of standardization of dialysis adequacy, insufficient neuropsychological tests, and performed a cross-sectional comparison.…”

Section: Discussionsupporting

confidence: 89%

Kidney Transplantation Improves Cognitive and Psychomotor Functions in Adult Hemodialysis Patients

Radić

Ljutić²,

Radić³

et al. 2011

Am J Nephrol

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Background: Kidney failure is believed to have a negative impact on cognitive function, and cognitive impairment is common among maintenance hemodialysis (HD) patients. Previous studies have shown a beneficial effect of kidney transplantation in certain cognitive tests but not across all cognitive domains assessed. But, most of these studies performed a cross-sectional analysis, suffered from lack of standardization of adequate dialysis dose, hemoglobin level, and insufficient sensitivity of neuropsychological tests. The aim of this study was to evaluate the effect of successful kidney transplantation on cognitive and psychomotor function in adequately dialyzed HD patients without severe anemia, using sensitive neuropsychological tests. Methods: Twenty-one medically stable patients (aged 45.1 ± 7.9 years) on maintenance HD (7.6 ± 4.2 years) were investigated before and 20.5 ± 8.5 months after successful kidney transplantation using Complex Reactiometer Drenovac, a battery of computer-generated psychological tests which measure a simple visual discrimination of signal location, short-term memory, simple convergent visual orientation and convergent thinking. Results: Our findings indicated significantly better cognitive and psychomotor performance after transplantation on tests that assess processing speed, attention, short time memory, convergent thinking and executive functioning. Also, significant negative correlation between follow-up time after transplantation and cognitive and psychomotor performance in minimum time of solving test of convergent thinking was found. Conclusion: We conclude that cognitive and psychomotor functions are superior after successful kidney transplantation compared with HD, and that early beneficial effects of transplantation are not transient and cognitive and psychomotor performance might be even improved in time following successful transplantation.

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Section: Discussionsupporting

confidence: 89%

Kidney Transplantation Improves Cognitive and Psychomotor Functions in Adult Hemodialysis Patients

Radić

Ljutić²,

Radić³

et al. 2011

Am J Nephrol

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“…Findings revealed that patients with uremia performed significantly worse than healthy controls with respect to the total acquisition and delayed retention of noncontextualized verbal information (i.e., California Verbal Learning Test-2nd Edition; CVLT-II-total acquisition trials 1-5 and delayed recall) (Delis et al 2000) and aspects of executive functioning such as inhibition (i.e., Delis-Kaplan Executive Function System [DKEFS]; Color-Word Interference Test) (Delis et al 2001) and conceptual set-shifting (i.e., DKEFS; Trail-Making Test). These findings were subsequently replicated by Gelb and colleagues (Gelb et al 2008).…”

Section: Neuropsychological Functioning In Chronic Kidney Diseasementioning

confidence: 73%

“…Ryan et al (1980) 24 uremic patients compared to 24 neurological and 24 medicalpsychiatric controls 11 subtests of the WAIS (Wechsler 1955) Relative to both medical control groups, uremic patients showed much less deficit relative to their own mean on information, comprehension and vocabulary and much greater deficit relative to their own mean on block design and object assembly Souheaver et al (1982) 24 uremic patients compared to 24 neurological and 24 medicalpsychiatric controls Halstead Reitan Battery (Reitan and Davison 1974) Relative to the medical-psychiatric group uremic patients were more impaired, relative to their own mean, on tests of visual alertness, flexible thinking and rapid information processing (i.e., trail-making test part B) Thornton et al (2007) 51 uremic patients with GFR<60 and, 55-age and education matched controls CVLT-II trials 1-5, 20-min delayed recall (Delis et al 2000) Healthy controls significantly outperformed uremic patients with respect to all primary measures. Effect sizes were largest for verbal memory scores D-KEFS, trail-making test and colour word interference (Delis et al 2001) No significant associations between measures of illness severity and cognition were found Gelb et al (2008) 45 uremic outpatients and 49 healthy controls CVLT-II trials 1-5 recall score, 20-min delayed recall (Delis et al 2000) Patients with uremia performed significantly worse on all measures relative to matched controls. Effect sizes were largest for verbal memory scores D-KEFS, trail-making test and colour word interference (Delis et al, 2001) Post-transplant patients performed significantly more poorly than healthy controls on verbal learning, memory (i.e., total acquisition and delayed retention) and aspects of executive functioning (i.e., inhibition and conceptual-set shifting) No significant associations between measures of illness severity and cognitive function GFR glomerular filtration rate (milliletres/minute/1.73 m 2 bsa), WAIS Wechsler adult intelligence scale, CVLT-II California verbal learning test2nd edition, D-KEFS Delis-Kaplan executive function system Ginn (1975) 24 uremic patients some receiving dialysis.…”

Section: Neuropsychological Functioning In Chronic Kidney Diseasementioning

confidence: 99%

Adult Chronic Kidney Disease: Neurocognition in Chronic Renal Failure

2009

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In recent years there has been a keen interest in the neurocognitive sequelae of renal failure and subsequent end-stage renal disease given its increasing prevalence and incidence. This review article summarizes the relevant information on cognitive functioning in chronic kidney disease in adults before the initiation of dialysis, after the initiation of dialysis, and after renal transplantation. In general, compared to pre-dialysis, there is an improvement in cognitive function after the institution of dialysis and further improvement after renal transplantation. Throughout the paper an attempt is made to highlight the importance of considering disease related variables in the neuropsychological assessment of individuals with chronic kidney disease. The paper concludes with a discussion of future avenues of research.

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“…In addition to physiologic alterations, kidney disease may also precede severe, concomitant disturbances in affect, including depression, delirium, and sleep disorders [1,7]. Although kidney transplantation may mitigate the adverse effect of dialysis treatments [8] on certain cognitive domains, previous work suggests impairments in executive functioning, and verbal memory persist following surgical interventions [9,10]. Despite widespread clinical evidence supporting the link between chronic kidney disease and mental dysfunction, early clinical diagnosis, and lifestyle prevention remains inadequate thus far [1].…”

Section: Introductionmentioning

confidence: 99%

Free-Living Physical Activity, Executive Function, and Kidney Disease

Frith¹,

Loprinzi²

2017

J Mol Pathophysiol

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Objective: We evaluated the specific association between physical activity and cognition among older adults with chronic kidney disease in the United States. Methods: Data from the 1999-2002 National Health and Nutrition Examination Survey were used to identify 66 older adults, between 60 and 85 years, with complete data on selected study variables. Diagnosis of chronic kidney disease was assessed through self-report. Participation in physical activity was determined from self-report data. The digit symbol substitution test (DSST) was used to assess participant executive cognitive functioning tasks of pairing and free recall. Individuals were excluded if they had missing data on the study variables assessed, or if they self-reported having coronary artery disease, congestive heart failure, stroke, or a heart attack. Results: Physical activity was associated with higher cognitive performance in this sample. After adjustments, those meeting moderate to vigorous physical activity (MVPA) guidelines (vs. not) had an 8.77 higher DSST score (β = 8.77; 95% CI: 1.65-15.89; P = 0.02). Furthermore, after adjustments, for every 1 metabolic equivalent of task-min-month increase in MVPA, participants had a 0.0007 DSST increase (β = 0.0007; 95% CI: −0.0001-0.001; P = 0.08), although this result was not statistically significant. Conclusion: In this sample of older adults with chronic kidney disease, there was a positive association between physical activity participation and higher levels of cognitive functioning.

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Cognitive outcome following kidney transplantation

Abstract: Results suggest that, in comparison to controls, verbal memory and executive functioning skills are worse in both CKD and TX patients. Further research is needed to determine the etiology and extent of cognitive compromise, as well as to assess the clinical implications of these findings.

Cited by 52 publications

References 17 publications

Kidney Transplantation Improves Cognitive and Psychomotor Functions in Adult Hemodialysis Patients

Kidney Transplantation Improves Cognitive and Psychomotor Functions in Adult Hemodialysis Patients

Adult Chronic Kidney Disease: Neurocognition in Chronic Renal Failure

Free-Living Physical Activity, Executive Function, and Kidney Disease

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