Cognitive Testing in Patients with CKD: The Problem of Missing Cases

Abstract

We excluded almost one half of eligible patients from cognitive testing due to visual, motivational, or motor difficulties. Our findings are consistent with exclusion categories reported from the literature. We should be aware that, because of disease-related limitations, conclusions about cognitive functioning in the CKD population may be biased. In the future, nonvisual and nonverbal cognitive testing can be a valuable resource.

Peritoneal dialysis is associated with better cognitive function than hemodialysis over a one-year course

“…Suggestions for a range of alternative instruments such as nonvisual tests have already been published. 36 Several limitations of our study should be noted. First, when CT is administered repeatedly, there may be a risk of bias from learning effects.…”

“…We documented a large proportion of patients with poorer conditions who could not participate in CT due to several reasons. 36 Exclusions due to reasons such as visual and motor impairment possibly may have resulted in both an over-and underestimation of CF. 36 Patients who may have noticed cognitive impairment themselves and would have performed worse over time c l i n i c a l i n v e s t i g a t i o n D Neumann et al: Neurocognition in patients with ESRD might have refrained from participating in CT by indicating a "lack of motivation."…”

“…36 Exclusions due to reasons such as visual and motor impairment possibly may have resulted in both an over-and underestimation of CF. 36 Patients who may have noticed cognitive impairment themselves and would have performed worse over time c l i n i c a l i n v e s t i g a t i o n D Neumann et al: Neurocognition in patients with ESRD might have refrained from participating in CT by indicating a "lack of motivation." A loss to follow-up of patients including mortality and change of treatment modality may have partially biased the findings in terms of a "survivor bias" and contributed to the observed improvements in CF over time.…”

Screening of Cognitive Impairment in the Dialysis Population: A Scoping Review

“…In the recently published Choice of Renal Replacement Therapy (CORETH) project, almost half of the 767 eligible dialysis patients had missing cognitive testing data [65]. The patients with missing data were those with disease-related limitations for cognitive testing such as visual, motivational, or motor difficulties.…”

Pulse-wave velocity is associated with cognitive impairment in haemodialysis patients

“…Although limited by its cross-sectional design and relatively small patient numbers, the current study raises the question as to whether increased arterial stiffness might partly explain the higher rates of cognitive impairment and aggravated cognitive decline seen in dialysis patients. Noteworthy is that the patients included were self-selected, increasing the chance of recruitment bias, an inherent problem in such studies [ 22 ]. Furthermore, patients were assessed immediately prior to a dialysis session.…”