Patterns of Cognitive Impairment in Hemodialysis Patients and Related Factors including Depression and Anxiety

Golenia, Aleksandra; Żołek, Norbert; Olejnik, Piotr; Żebrowski, Paweł; Małyszko, Jolanta

doi:10.3390/jcm12093119

Cited by 5 publications

(2 citation statements)

References 34 publications

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“…patients with ESKD demonstrated problems in tests assessing executive function in the first months of RRT, while there were no difficulties in general cognitive skills [ 27 ]. Furthermore, a few studies, assessing cognitive abilities in CKD patients, including our previously published study, found verbal fluency to be the most affected domain, which reflects executive dysfunction [ 3 , 4 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

The Clock Drawing Task reveals executive dysfunction in the dialysis population – an underrecognized and underestimated problem

Olejnik,

Golenia,

Maciejewska

et al. 2024

Renal Failure

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Aim of the study The study aimed to assess the prevalence of executive function impairment among patients with chronic kidney disease (CKD) undergoing dialysis, with no subjective cognitive problems and with normal global cognition on the Mini-Mental State Examination (MMSE). We also investigated the relationship between cardiovascular risk factors and cognitive test results. Rationale for the study Patients with CKD, including those undergoing renal replacement therapy, are at a higher risk of developing cognitive impairment (CI) than the general population. Recent research has shown CI to be a growing problem among CKD patients worldwide. Yet, it remains underdiagnosed, even though it may significantly influence the lives of patients. Materials and methods In this cross-sectional, prospective study, 58 dialysis patients with no cognitive decline on the MMSE screening were assessed for executive function impairment using the Executive Clock-Drawing Task (CLOX). Moreover, past medical history, demographic data, and laboratory test results were collected. Results The mean patient age was 59.47 ± 14.98 years, and the mean duration of dialysis was 45.93 ± 48.49 months. The prevalence of executive function impairment amounted to 8.6%. Moreover, remarkably similar pattern of clock drawing was observed, with numbers written outside the clock face in the CLOX1 test. Conclusions Executive dysfunctions in dialysis patients may manifest itself before the onset of global cognitive impairment. There appear to be a deficit in the spatial domain as well. Better education may play a protective role.

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Section: Discussionmentioning

confidence: 99%

The Clock Drawing Task reveals executive dysfunction in the dialysis population – an underrecognized and underestimated problem

Olejnik,

Golenia,

Maciejewska

et al. 2024

Renal Failure

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“…Kidney transplantation (KT) is the treatment of choice for most patients with end-stage kidney disease to increase survival and quality of life [ 1 ]. Cognitive impairment (CI) is common in hemodialysis and peritoneal dialysis patients [ 2 , 3 ] and may also be detected in kidney transplant candidates [ 4 ]. CI prior to KT is associated with a lower likelihood of being listed for transplant and with a longer waitlist for transplantation [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Cognitive Impairment and Anxiety Are Prevalent in Kidney Transplant Recipients

Golenia,

Olejnik,

Żołek

et al. 2023

Kidney Blood Press Res

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Introduction: Cognitive impairment (CI) is common in end-stage kidney disease (ESKD), including kidney transplant recipients. Patients with cognitive problems may find it difficult to comply with medical recommendations after kidney transplantation (KT), which can be the cause of many complications, poorer prognosis, and increased hospitalization rates after transplantation. Additionally, some patients after KT may experience depression and anxiety, which are prevalent comorbidities in patients with ESKD. Methods: In this single-center, cross-sectional study, we included 56 consecutive adult patients after KT. Cognitive function was assessed using the Addenbrooke Cognitive Test III (ACE III). In addition, all patients were screened for depression and anxiety using the Hospital Anxiety and Depression Scale (HADS). The impact of immunosuppressive therapy and other disease-related variables on cognitive function was also assessed. Results: A total of 56 KT patients, with a mean age of 50.3 ± 11.7 years, transplanted ≤35 months ago were included in the study. The prevalence of CI was 30%. Compared with cognitively unimpaired patients, patients with CI scored significantly lower in all cognitive domains. Furthermore, better cognitive functioning after KT was significantly associated with more years of schooling. We found no significant correlation between CI and age at assessment, duration of dialysis before KT, creatinine levels, creatinine clearance, uric acid levels, hemoglobin levels, comorbid cardiovascular diseases, and immunosuppressive therapy. In addition, the prevalence of depression and anxiety in screening tests was 12.5% and 27%, respectively, and patients receiving higher daily dose of prednisone had higher HADS scores on both the depression and anxiety subscales (not statistically significant). Discussion: Cognitive disorders are a relevant issue in kidney transplant recipients. There might be many factors, both before and after KT, that have a negative impact on cognition. Therefore, further research is needed to increase knowledge about the course and profile of cognitive function after KT.

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Cognitive impairment in patients awaiting kidney and liver transplantation—A clinically relevant problem?

Golenia,

Olejnik,

Grusiecka‐Stańczyk

et al. 2024

Brain and Behavior

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IntroductionCognitive impairment (CI) is common in both end‐stage kidney disease (ESKD) and alcohol‐related liver cirrhosis. The aim of this study was to assess the prevalence and patterns of CI in patients awaiting kidney and liver transplantation, and to identify its determinants.MethodsIn this cross‐sectional, prospective study, 31 consecutive patients with ESKD and 31 consecutive patients with alcohol‐related liver cirrhosis, all currently on transplant waiting lists, were screened for cognitive decline using the Addenbrooke's Cognitive Examination. Medical history, demographics, and laboratory test results were also collected.ResultsThe prevalence of CI among patients with ESKD and alcohol‐related liver cirrhosis was 26% and 90%, respectively. In both groups, memory was the most affected cognitive domain, along with verbal fluency in patients with ESKD, and visuospatial abilities in patients with alcoholic cirrhosis. The most statistically significant increase in the prevalence of CI was found in patients with lower educational attainment, in both alcohol‐related liver cirrhosis and ESKD populations as well as in older patients with alcoholic cirrhosis. Furthermore, better cognitive functioning in ESKD patients was associated with higher levels of total lymphocyte count and alanine transaminase (ALT), and in alcohol‐related liver cirrhosis patients with higher levels of ALT and aspartate transaminase. A nonsignificant trend toward lower memory domain scores was also observed with increasing ammonia levels and increasing severity of liver disease (higher Child–Pugh scores). Finally, suboptimal performance on the screening test was correlated with the severity of liver disease as assessed by the Model for End‐Stage Liver Disease Sodium (MELD‐Na), but not at the statistically significant level.ConclusionsThe prevalence of CI, especially in patients with alcohol‐related liver cirrhosis, is high and can be a significant clinical problem, negatively affecting the transplantation process. Routine screening tests in this group would contribute to the implementation of appropriate management, such as rehabilitation program or psychosocial treatments and facilitate the provision of specialized health care.

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Patterns of Cognitive Impairment in Hemodialysis Patients and Related Factors including Depression and Anxiety

Cited by 5 publications

References 34 publications

The Clock Drawing Task reveals executive dysfunction in the dialysis population – an underrecognized and underestimated problem

The Clock Drawing Task reveals executive dysfunction in the dialysis population – an underrecognized and underestimated problem

Cognitive Impairment and Anxiety Are Prevalent in Kidney Transplant Recipients

Cognitive impairment in patients awaiting kidney and liver transplantation—A clinically relevant problem?

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